Individual
NICOLE ALEXANDRIA LANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1338 COLEGATE DR, MARIETTA, OH 45750-1369
(740) 373-6669
Mailing address
1338 COLEGATE DR, MARIETTA, OH 45750-1369
(740) 373-6669
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT010996
OH
Other
Enumeration date
09/15/2020
Last updated
09/15/2020
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