Individual
KENDRA RAE NICKOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2321 S 3RD ST W # 1332, MISSOULA, MT 59801-1332
(406) 214-3131
Mailing address
2321 S 3RD ST W, MISSOULA, MT 59801-1332
(406) 214-3131
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTP-OT-LIC-9609
MT
Other
Enumeration date
03/06/2023
Last updated
03/06/2023
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