Individual
BRITTANY PAIGE NICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
100 W US HIGHWAY 60, MOUNTAIN VIEW, MO 65548-8542
(417) 934-7050
(417) 934-7151
Mailing address
703 KAITLIN DR, MOUNTAIN VIEW, MO 65548-8487
(573) 300-8207
(417) 934-7151
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2019037262
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2019037262
MISSOURI LICENSURE
MO
Enumeration date
01/20/2020
Last updated
11/27/2023
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