Individual
MRS. NICOLE EVERETT LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
65 WHITE ST, FT OGLETHORPE, GA 30742-3694
(423) 309-7975
Mailing address
PO BOX 5496, FT OGLETHORPE, GA 30742-0696
(423) 309-7975
(423) 910-1467
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT004937
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1516981
—
TN
05
—
350828953A
—
GA
Enumeration date
07/28/2009
Last updated
01/26/2018
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