Individual
DANIELLE PAGE NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L, OTD
Contact information
Practice address
2535 LONE STAR DR, DALLAS, TX 75212-6313
(214) 467-9787
Mailing address
3655 PRAIRIE WATERS DR APT 5102, GRAND PRAIRIE, TX 75052-7097
(815) 573-3144
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
121899
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121899
ECPTOTE
TX
01
—
455667
NBCOT
—
Enumeration date
06/28/2021
Last updated
06/28/2021
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