Individual
MS. JANINE THERESE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
450 LAKE DR, MELLEN, WI 54546-9750
(715) 274-5706
Mailing address
14721 N STATE HIGHWAY 169, SAXON, WI 54559-9304
(715) 893-5019
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5027-27
WI
Other
Enumeration date
09/19/2013
Last updated
09/19/2013
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