Nickole Mary Mensen I

NPI #1558936930 in White Bear Lake, Minnesota

Provider Information

NPI Number: 1558936930
Entity Type: Individual
Name: Nickole Mary Mensen I
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: May 26, 2021
Last Updated: May 26, 2021

Practice Location

Address: 1011 MEADOWLANDS DR STE 1AND2
City: White Bear Lake
State: Minnesota
ZIP Code: 55127-2339
Phone: (612) 445-0301

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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