Individual
NICOLE RENEE GROOMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
7100 DEERWESTER DR, CINCINNATI, OH 45236
(513) 745-9925
Mailing address
2261 SIESTA DR, BATAVIA, OH 45103
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA05059
OH
Other
Enumeration date
12/19/2012
Last updated
12/19/2012
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