Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251E1200X | Ergonomics | 1082 | ND |
Y | 225XE1200X | Ergonomics | 1082 | ND |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 1082 | ND |
NPI | 1366766107 |
---|---|
Provider Name | Crystal Nelson |
First Address | West Fargo, ND 58078-1400 |
Second Address | West Fargo, ND 58078-1400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2010 |
Last Update Date | 10/06/2020 |