Individual
KERRI NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
119 JOE LICK RD, SCOTT TWP, PA 18447-7626
(570) 563-2759
Mailing address
119 JOE LICK RD, SCOTT TWP, PA 18447-7626
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP003158L
PA
Other
Enumeration date
11/22/2010
Last updated
11/22/2010
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