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Individual

MS. ANNA NIKITSCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
515 PUEBLO DR, NEW LENOX, IL 60451-5621
(708) 220-5872
Mailing address
515 PUEBLO DR, NEW LENOX, IL 60451-5621
(708) 220-5872

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057002806
IL

Other

Enumeration date
12/08/2011
Last updated
09/09/2016
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