Individual
NICOLE RENEE NICHOLS-BREER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 W NORTH 12TH ST, SHELBYVILLE, IL 62565-9554
(217) 774-2111
Mailing address
626 N 2375 EAST RD, MODE, IL 62444-4039
(217) 690-2983
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
07/28/2017
Last updated
07/28/2017
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