Individual
MRS. NICOLE CORINNE WALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
82 RESTORATIVE LN, MIDDLETOWN, NY 10940-7662
(845) 978-9966
Mailing address
82 RESTORATIVE LN, MIDDLETOWN, NY 10940-7662
(845) 978-9966
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
007487-01
NY
Other
Enumeration date
11/20/2020
Last updated
11/20/2020
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