Individual
NICOLE MARIE EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2306 WADE AVE, ASHTABULA, OH 44004-9435
(440) 813-2963
Mailing address
613 LAKE ERIE ST, CONNEAUT, OH 44030-1358
(440) 319-8476
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT008477
OH
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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