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General NPI Number Information
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NPI Number | 1184107252
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Entity Type | Individual
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Provider Name | MATTHEW RAYMOND NUESSLE OTR/L
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Gender | Male
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Dates
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Enumeration Date | 09/13/2018
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 7455 ARROYO CROSSING PKWY STE 220
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City | LAS VEGAS
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State | NV
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Zip | 89113-4088
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Country | US
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Telephone | 702-761-6449
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Fax | 702-925-0282
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Provider Business Mailing Address
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Address Line | 7455 ARROYO CROSSING PKWY STE 220
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City | LAS VEGAS
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State | NV
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Zip | 89113-4088
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Country | US
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Telephone | 702-761-6449
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Fax | 702-925-0282
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT-2086
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License Number State | NV
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