Individual
KELLY MARIE NICOLOSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
9670 LAS CASAS DR, FORT MYERS, FL 33919-8409
(239) 466-0890
Mailing address
9670 LAS CASAS DR, FORT MYERS, FL 33919-8409
(239) 466-0890
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT11094
FL
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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