Individual provider · NPI-1

Nicole Davis

Occupational Therapist · Saint Clair Shores, MI

NPI number1962589325
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1962589325
Entity type
Individual (NPI-1)
Name
Nicole Davis
Sex
Female
Sole proprietor
Yes
Enumeration date
Nov 1, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225X00000X Occupational Therapist5201005450MIYes

Practice location

23161 Greater Mack Ave
Saint Clair Shores, MI 48080-1956

Phone 586-779-8892 · Fax 586-779-2869

Mailing address

23161 Greater Mack Ave
Saint Clair Shores, MI 48080-1956

Phone 586-779-8892 · Fax 586-779-2869

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