Nicole White, OTR

Individual provider Active NPI Occupational Therapist · Watertown, MN

NPI 1710159405 · NPPES record last updated Apr 2, 2008

Key facts

NPI
1710159405
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
102687 (MN)
Practice address
200 Lewis Ave S
Ste#210
Watertown, MN 55388-4545
Phone
(952) 955-2242
Fax
(952) 955-2010
NPI assigned
Apr 2, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
102687MNMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 102687 MN Yes

Addresses

Primary practice location

200 Lewis Ave S
Ste#210
Watertown, MN 55388-4545

Mailing address

200 Lewis Ave S
Ste#210
Watertown, MN 55388-4545
Phone (952) 955-2242

Other providers in Watertown, MN

All providers in Watertown, MN · Occupational Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.