Individual
MRS. GABRIELLE A NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
3229 S STONINGTON AVE, EAGLE, ID 83616
(208) 371-6868
Mailing address
3229 S STONINGTON AVE, EAGLE, ID 83616
(208) 371-6868
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT727
ID
Other
Enumeration date
02/01/2008
Last updated
02/01/2008
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