Individual
JESSICA VOGEL NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2425 20TH ST, VERO BEACH, FL 32960-6615
(772) 778-9933
Mailing address
926 BEAVERDALE LN, ROCKLEDGE, FL 32955-3912
(407) 733-0555
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA11679
FL
Other
Enumeration date
07/11/2018
Last updated
07/11/2018
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