Individual
NICOLE BAZIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L, CLT
Contact information
Practice address
901 S MAIN ST, OTTAWA, KS 66067-3315
(785) 229-8348
Mailing address
901 S MAIN ST, OTTAWA, KS 66067-3315
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-00972
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18-00972
KANSAS STATE BOARD OF HEALING ARTS
KS
Enumeration date
03/16/2022
Last updated
03/16/2022
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