Nicole Wilson
Occupational Therapist in Davie, FL. Individual provider (NPI-1).
NPI number1003147489
StatusActive
Last updated in NPPESNov 18, 2010
Details
- NPI
- 1003147489
- Entity type
- Individual (NPI-1)
- Name
- Nicole Wilson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 25, 2010
- Last updated
- Nov 18, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225X00000X | Occupational Therapist | OT13641 | FL | Yes |
Practice location
3301 College AveDavie, FL 33314-7721
Phone 954-262-7124
Mailing address
1734 E Harmony Lake CirDavie, FL 33324-7123
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