Individual
MRS. NICOLE RAE SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2927 S FISH HATCHERY RD, FITCHBURG, WI 53711
(608) 816-6394
Mailing address
2927 S FISH HATCHERY RD, FITCHBURG, WI 53711-6498
(608) 819-6394
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5534-27
WI
226000000X
Recreational Therapist Assistant
5534-27
WI
Other
Enumeration date
09/07/2018
Last updated
09/07/2018
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