Individual
NIKKI S STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
123 MILLPORT CIRCLE, SUITE 201, GREENVILLE, SC 28607-5526
(704) 831-5050
(704) 831-5055
Mailing address
123 MILLPORT CIRCLE, SUITE 201, GREENVILLE, SC 28607-5526
(704) 831-5050
(704) 831-5055
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2655
SC
Other
Enumeration date
09/28/2006
Last updated
07/20/2007
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