Individual provider · NPI-1

Nicole Elizabeth Boyington, OTD

Occupational Therapist · Waukesha, WI

NPI number1962779116

StatusActive

Last updated in NPPESMay 19, 2020

Details

NPI: 1962779116
Entity type: Individual (NPI-1)
Name: Nicole Elizabeth Boyington
Credential: OTD
Sex: Female
Sole proprietor: No
Enumeration date: Nov 16, 2011
Certification date: May 19, 2020
Last updated: May 19, 2020

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
225X00000X	Occupational Therapist	3773-026	WI	Yes
225XE0001X	Occupational Therapist, Environmental Modification	–	–
225XG0600X	Occupational Therapist, Gerontology	–	–
225XM0800X	Occupational Therapist, Mental Health	–	–
225XP0019X	Occupational Therapist, Physical Rehabilitation	–	–
225XP0200X	Occupational Therapist, Pediatrics	–	–

Other names

Nicole Elizabeth Glisczinski (Former Name)

Practice location

1180 Pioneer Trl
Waukesha, WI 53186-5490

Phone 262-226-2050

Mailing address

1180 Pioneer Trl
Waukesha, WI 53186-5490

Phone 262-226-2050

Other practice locations

1625 Coldwater Creek Dr
Waukesha, WI 53188-8028

Phone 262-251-8800

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