Individual
STACEY NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
1573 CAMPUS DELIVERY COLORADO STATE UNIVERSITY, FORT COLLINS, CO 80523-0001
(970) 491-6669
Mailing address
144 N MCKINLEY AVE, FORT COLLINS, CO 80521-2320
(614) 204-3248
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT.0002710
CO
Other
Enumeration date
07/29/2020
Last updated
07/29/2020
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