Individual
NICOLE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
925 W SOUTH BLVD, TROY, MI 48085-1502
(248) 729-4491
Mailing address
925 W SOUTH BLVD, TROY, MI 48085-1502
(248) 729-4491
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201008872
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5201008872
—
MI
Enumeration date
11/19/2018
Last updated
11/19/2018
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