Individual
MRS. NICHOLE CHRISTINE KISGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1782 SCARLETT AVE, NORTH PORT, FL 34289-9478
(941) 426-1791
Mailing address
1782 SCARLETT AVE, NORTH PORT, FL 34289-9478
(941) 426-1791
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 9549
FL
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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