Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT-2225 | NV |
NPI | 1194388439 |
---|---|
Provider Name | Michael Shay Nielson |
First Address | Mesquite, NV 89024-0757 |
Second Address | Mesquite, NV 89027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2019 |
Last Update Date | 22/04/2019 |