Individual
NICOLE A MENTINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3400 UNION AVE, SHEBOYGAN, WI 53081-8426
(920) 828-2700
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7049-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100197279
—
WI
Enumeration date
02/01/2022
Last updated
02/04/2026
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