Individual
NICOLE ANN DAVAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
6800 TELEPHONE RD, LAKE WORTH, TX 76135-2856
(817) 306-4200
Mailing address
413 ARBOR LAWN DR, BURLESON, TX 76028-4063
(817) 295-2258
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
110168
TX
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
03/15/2007
Last updated
07/22/2008
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