Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 2218 | MA |
NPI | 1104103571 |
---|---|
Provider Name | Valerie Nichols |
First Address | Adams, MA 01220-9717 |
Second Address | Pittsfield, MA 01201-3540 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2011 |
Last Update Date | 13/11/2011 |