Individual
NICHOLE DENNISE CHAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4181 MEDFORD DR NW, CONCORD, NC 28027-4517
(704) 788-4461
Mailing address
4181 MEDFORD DR NW, CONCORD, NC 28027-4517
(704) 788-4461
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
8332
NC
Other
Enumeration date
05/05/2015
Last updated
05/05/2015
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