Individual
STACY NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2428 CANYON LAKE DR, RAPID CITY, SD 57702-2402
(605) 415-1750
(605) 716-6316
Mailing address
2428 CANYON LAKE DR, RAPID CITY, SD 57702-2402
(605) 415-1750
(605) 716-6316
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0595
SD
Other
Enumeration date
09/09/2008
Last updated
09/09/2008
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