Individual
MICHELLE NIETO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8724 CULLEN CT, ELK GROVE, CA 95624-1720
(916) 747-1313
Mailing address
8724 CULLEN CT, ELK GROVE, CA 95624-1720
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3080
CA
Other
Enumeration date
04/13/2016
Last updated
04/13/2016
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