Individual
LISA E NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
514 HUMBOLDT AVE, SAINT PAUL, MN 55107-4013
(651) 310-1234
Mailing address
8906 NEWTON AVE S, BLOOMINGTON, MN 55431-2017
(952) 886-0639
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
100117
MN
Other
Enumeration date
07/16/2007
Last updated
07/16/2007
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