Individual
NICOLE REID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2230 EXECUTIVE DR, HAMPTON, VA 23666-2430
(757) 224-2262
Mailing address
7240 BRAY RD, HAYES, VA 23072-3450
(703) 965-2045
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
T62784340
VA
Other
Enumeration date
11/10/2020
Last updated
11/10/2020
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