Individual
NICOLE J ROSALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT,OT
Contact information
Practice address
2414 KOHLER MEMORIAL DR, SHEBOYGAN, WI 53081-3129
(920) 459-1485
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(822) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4469026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100043616
—
WI
Enumeration date
02/12/2008
Last updated
04/08/2024
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