Individual
NICOLE LATZIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1801 AMERICAN BLVD E, BLOOMINGTON, MN 55425-1232
(612) 767-7222
Mailing address
1801 AMERICAN BLVD E, BLOOMINGTON, MN 55425-1232
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
105930
MN
Other
Enumeration date
04/25/2019
Last updated
10/19/2021
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