Individual
MRS. NICOLETTE SUE MOURER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT-A
Contact information
Practice address
3917 KEENER LN, HARRISON, AR 72601-7522
(870) 302-9277
Mailing address
2364 HIGHWAY 65 S, HARRISON, AR 72601-7400
(574) 249-2498
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
15631
NC
224Z00000X
Occupational Therapy Assistant
217730
TX
224Z00000X
Occupational Therapy Assistant
32002317A
IN
224Z00000X
Occupational Therapy Assistant
5499
SC
224Z00000X
Occupational Therapy Assistant
Primary
OT-A1950
AR
224Z00000X
Occupational Therapy Assistant
OTA19300
FL
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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