Individual
ROBIN NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10915 W 133RD AVE, CEDAR LAKE, IN 46303-9706
(219) 390-7498
Mailing address
10915 W 133RD AVE, CEDAR LAKE, IN 46303-9706
(219) 390-7498
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002111A
IN
Other
Enumeration date
06/27/2014
Last updated
08/17/2015
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