Individual
MANDY NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
917 W CANFIELD AVE, COEUR D ALENE, ID 83815-9764
(208) 762-3502
Mailing address
4612 S WOODRUFF RD, SPOKANE VALLEY, WA 99206-9237
(509) 998-0690
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-2354
ID
Other
Enumeration date
03/12/2021
Last updated
03/12/2021
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