Individual
JOANNA NILSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
4112 OUTLOOK BLVD STE 96, PUEBLO, CO 81008-1667
(719) 562-6200
(719) 562-6225
Mailing address
2142 UTOPIA PKWY, WHITESTONE, NY 11357-4142
(718) 819-6805
(347) 841-9109
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
020889
NY
Other
Enumeration date
09/09/2016
Last updated
07/27/2020
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