Individual
CATHERINE ANN NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
6263 N GREEN BAY AVE, SEVEN OAKS, GLENDALE, WI 53209
(414) 351-0543
Mailing address
9823 N PORT WASHINGTON LN, MEQUON, WI 53092-6078
(262) 643-4650
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1402-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40582800
—
WI
Enumeration date
05/07/2008
Last updated
12/06/2012
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