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General NPI Number Information
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NPI Number | 1326976846
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Entity Type | Individual
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Provider Name | HALEY BERNICE NIELSEN
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Gender | Female
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Dates
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Enumeration Date | 05/13/2026
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Last Update Date | 05/13/2026
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Provider Practice Location Address
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Address Line | 615 MINNETONKA MILLS RD
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City | HOPKINS
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State | MN
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Zip | 55343-7203
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Country | US
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Telephone | 952-938-2761
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Fax |
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Provider Business Mailing Address
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Address Line | 5525 MAIN ST W
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City | MAPLE PLAIN
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State | MN
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Zip | 55359-9630
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Country | US
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Telephone | 952-356-5585
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Fax |
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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 | 105786
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License Number State | MN
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