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Individual

NICOLE JOAN RICHARDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
2121 WILLOW ST, VINCENNES, IN 47591-5355
(812) 882-1141
(812) 255-0045
Mailing address
PO BOX 5629, EVANSVILLE, IN 47716-5629
(502) 882-9379
(502) 805-0526

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056.013428
IL
225X00000X
Occupational Therapist
Primary
31007705A
IN

Other

Enumeration date
01/22/2020
Last updated
04/26/2022
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