Individual
NICOLE KISSMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
40936 W THORNBERRY LN, MARICOPA, AZ 85138-6572
(714) 423-7791
Mailing address
40936 W THORNBERRY LN, MARICOPA, AZ 85138-6572
(714) 423-7791
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
08/20/2019
Last updated
07/22/2024
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