Individual
PAULA NICOLE NUGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1000 LINCOLN DR, SOUTH CHARLESTON, WV 25309-2304
(304) 766-1722
(304) 766-8991
Mailing address
PO BOX 434, SHADY SPRING, WV 25918-0434
(304) 763-4895
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C1578
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C-1578
COTA LICENSE
WV
Enumeration date
02/21/2008
Last updated
02/21/2008
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