Individual
MISS MEGHAN ELIZABETH NICKOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
255 CENTRAL AVE, CHELSEA, MA 02150-3508
(617) 660-2601
Mailing address
255 CENTRAL AVE, CHELSEA, MA 02150-3508
(617) 660-2601
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3534
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119470352
—
MA
Enumeration date
09/18/2012
Last updated
09/18/2012
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