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Individual

MS. BETH GARDNER NICHOLSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR, CHT

Contact information

Practice address
3234 CAHABA HEIGHTS RD, VESTAVIA, AL 35243-1614
(205) 383-8579
(205) 298-9103
Mailing address
3269 BROOK HIGHLAND TRCE, BIRMINGHAM, AL 35242-5814
(205) 981-7167
(205) 298-9013

Taxonomy

Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
0133
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51005522
BLUE CROSS
AL
01
51510089
BLUE CROSS DME PROV #
AL
Enumeration date
10/24/2006
Last updated
11/14/2011
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