Individual
DANIELLE NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1998 E 1000 NORTH RD, SHELBYVILLE, IL 62565-4188
(217) 821-1783
Mailing address
1998 E 1000 NORTH RD, SHELBYVILLE, IL 62565-4188
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.003312
IL
Other
Enumeration date
01/21/2015
Last updated
01/21/2015
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