Individual
NICOLE M TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
320 SURREY RDG, EATON, CO 80615-8817
(970) 215-4889
(303) 270-2174
Mailing address
320 SURREY RDG, EATON, CO 80615-8817
(970) 215-4889
(303) 270-2174
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1052331
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1052331
NATIONAL BOARD CERTIFICAT
CO
Enumeration date
09/26/2007
Last updated
04/23/2019
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