Individual
NICOLE BERTOLINO BOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
900 S FRANKLIN ST STE 201, WAKE FOREST, NC 27587-2799
(973) 567-1913
Mailing address
900 S FRANKLIN ST STE 201, WAKE FOREST, NC 27587-2799
(919) 556-1700
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
14379
NC
225X00000X
Occupational Therapist
Primary
5469
SC
Other
Enumeration date
03/03/2019
Last updated
03/30/2023
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