Individual
MISS SARAH VITALE NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
216 MAIN ST, LAKE VILLAGE, AR 71653-1916
(870) 265-3950
(870) 265-2525
Mailing address
29 SUSIE B LAW RD, HOLLANDALE, MS 38748-9710
(601) 850-7634
(360) 368-6227
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3415
MS
Other
Enumeration date
07/18/2013
Last updated
10/29/2021
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