Individual
LAUREN ROSE NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
171 INTREPID LN, SYRACUSE, NY 13205-2548
(315) 437-4689
Mailing address
112 HUNTSHILL RD, SYRACUSE, NY 13209-1742
(315) 807-7533
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
028492
NY
Other
Enumeration date
08/24/2023
Last updated
10/07/2023
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