Individual
DENISE E NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
4920 E STATE ST STE 4, ROCKFORD, IL 61108-2262
(815) 637-1100
(815) 637-1200
Mailing address
4920 E STATE ST STE 4, ROCKFORD, IL 61108-2262
(815) 637-1100
(815) 637-1200
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056005205
IL
Other
Enumeration date
12/18/2006
Last updated
08/30/2023
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