Individual
NICOLE E KILGOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
134 SOUNDVIEW RD, BELLINGHAM, WA 98229-8916
(801) 631-2282
Mailing address
PO BOX 4111, BELLINGHAM, WA 98227-4111
(801) 631-2282
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
312785-4201
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31278542000001
BLUECROSS BLUSHIELD OF UT
UT
Enumeration date
06/27/2006
Last updated
07/28/2010
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