Individual
MISS MOLLIE SHANNON NUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1318 W IVY AVE, MOSES LAKE, WA 98837-2065
(509) 766-2670
(509) 766-2689
Mailing address
920 W IVY AVE, MOSES LAKE, WA 98837-2047
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00003359
WA
Other
Enumeration date
12/04/2012
Last updated
12/04/2012
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