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Individual

NICOLE K CRAVOTTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2719
(505) 272-2111
Mailing address
1601 PENNSYLVANIA ST NE UNIT A07, ALBUQUERQUE, NM 87110-5504
(234) 806-1046

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
12260
NC
224Z00000X
Occupational Therapy Assistant
OTA. 3104
OH
224Z00000X
Occupational Therapy Assistant
Primary
OTA4360
NM

Other

Enumeration date
10/07/2011
Last updated
09/24/2020
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