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Individual

NIKKI LYNN HENGST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
550 N 12TH ST, SUITE 120, LEMOYNE, PA 17043-1242
(717) 737-9818
(717) 737-2815
Mailing address
550 N 12TH ST, SUITE 120, LEMOYNE, PA 17043-1242
(717) 737-9818
(717) 737-2815

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP005906
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OP005906
COTA LIC NBR
PA
Enumeration date
01/29/2007
Last updated
07/08/2007
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