Individual
ELYSE NICOLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
29 N ACADEMY ST, GREENVILLE, SC 29601-2629
(864) 331-1350
Mailing address
300 E MCBEE AVE, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
118832
TX
225X00000X
Occupational Therapist
Primary
6350
SC
Other
Enumeration date
01/25/2018
Last updated
02/11/2022
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