Most Relevant Information
Provider Data
| NPI Number: | 1003393000 |
| Provider Name: | SHAUNA R NELSON OTR/L, CLT |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: | 453 |
Most Important Dates
| Enumeration Date: | 07/23/2018 |
| Last Updated: | 11/02/2020 |
Provider Practice Location
1711 GOLD DR S STE 120
FARGO
ND
581036416
Practice Location Phone/Fax
| Phone: | 7014519417 |
| Fax: |
Provider Mailing Location
4450 31ST AVE S STE 104
FARGO
ND
581044557
Provider Mailing Phone/Fax
| Phone: | 0174519417 |
| Fax: |