Individual
NICOLE KRUEGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
216 ROBBINS REST CIR, DAVENPORT, FL 33896-5204
(608) 574-4483
Mailing address
216 ROBBINS REST CIR, DAVENPORT, FL 33896-5204
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
1193489
FL
Other
Enumeration date
12/19/2012
Last updated
12/19/2012
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