Individual
NICOLE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
5840 INTERFACE DR STE 400, ANN ARBOR, MI 48103-9176
(734) 627-8001
(734) 433-1989
Mailing address
5840 INTERFACE DR STE 400, ANN ARBOR, MI 48103-9176
(734) 627-8015
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009989
MI
Other
Enumeration date
11/07/2017
Last updated
11/07/2017
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