Kelby Renee Nicholson, COTA
Occupational Therapy Assistant in West Memphis, AR. Individual provider (NPI-1).
NPI number1174126338
StatusActive
Last updated in NPPESNov 19, 2020
Details
- NPI
- 1174126338
- Entity type
- Individual (NPI-1)
- Name
- Kelby Renee Nicholson
- Credential
- COTA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 19, 2020
- Certification date
- Nov 19, 2020
- Last updated
- Nov 19, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 224Z00000X | Occupational Therapy Assistant | OT-A1668 | AR | Yes |
Practice location
610 N Missouri St Ste 1West Memphis, AR 72301-3148
Phone 870-400-0179 · Fax 870-400-0479
Mailing address
610 N Missouri St Ste 1West Memphis, AR 72301-3148
Phone 870-400-0179 · Fax 870-400-0479
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Other Occupational Therapy Assistant providers in West Memphis, AR
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- Alannah Conrey, COTA/LNPI 1073973756
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All 17 Occupational Therapy Assistant providers in West Memphis · All 851 providers in West Memphis
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