Individual
NICOLE LYNN DIBERARDINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
303 N HURSTBOURNE PKWY, SUITE 200, LOUISVILLE, KY 40222-5185
(502) 412-5847
Mailing address
9492 BIRCH RUN RD, MILLINGTON, MI 48746-9781
(989) 295-7906
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201006488
MI
Other
Enumeration date
07/10/2013
Last updated
07/10/2013
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