Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nicole Tetrault, OTR

Individual provider Occupational Therapist · NPI 1568873644

Nicole Tetrault, OTR is an Occupational Therapist in Shoreview, Minnesota. Practices as a sole proprietor and works from 2 locations. Licensed in Minnesota.

Licensed in
MN
In the registry since
2014
Specialties on file
2
What do these letters mean?
OTR — Occupational Therapist, Registered
A nationally registered occupational therapist.

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Practice location Address checks out

490 Highway 96 W Ste 300
Shoreview, MN 55126-1961
Phone: (651) 451-3016
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4638 Victor Path Ste 100, Hugo, MN 55038-4732 — (651) 407-3777

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 104647 (MN)
Occupational Therapist Taxonomy 225X00000X

Record details

NPI number1568873644
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTR
Sole proprietorYes
NPI enumeratedMay 12, 2014
Last updated in NPPESNovember 29, 2022
Certification dateNovember 29, 2022

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