Provider Demographics
NPI:1497965156
Name:NIELSEN, CHRISTIAN LAURITS (MT-BC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:LAURITS
Last Name:NIELSEN
Suffix:
Gender:M
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 867
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MN
Mailing Address - Zip Code:55388-0867
Mailing Address - Country:US
Mailing Address - Phone:952-221-1857
Mailing Address - Fax:952-955-3272
Practice Address - Street 1:9908 STATE HIGHWAY 25 SW
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MN
Practice Address - Zip Code:55388-0867
Practice Address - Country:US
Practice Address - Phone:952-221-1857
Practice Address - Fax:952-955-3272
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist