Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 118756 | TX |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT60642487 | WA |
NPI | 1003262544 |
---|---|
Provider Name | Susan Nielson |
First Address | Houston, TX 77007-8337 |
Second Address | Omaha, NE 68154-5260 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2016 |
Last Update Date | 15/10/2021 |