Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 895 | NE |
NPI | 1013325208 |
---|---|
Provider Name | Nicole Harrington |
First Address | Grand Island, NE 68801-2321 |
Second Address | Grand Island, NE 68801-2321 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2014 |
Last Update Date | 31/07/2014 |