Individual
NICOLE CARLA IAMMATTEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2795 PILOT KNOB RD STE 100, EAGAN, MN 55121-1930
(651) 994-9644
Mailing address
4058 DEERWOOD TRL, EAGAN, MN 55122-1889
(651) 994-9644
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
102786
MN
Other
Enumeration date
01/09/2008
Last updated
01/09/2008
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