Individual
NICHOLE SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3612 CROFTVIEW TER, MINNETONKA, MN 55345-1111
(651) 442-8880
Mailing address
3612 CROFTVIEW TER, MINNETONKA, MN 55345-1111
(651) 442-8880
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
01/26/2022
Last updated
01/26/2022
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