Individual
NANCY ELLIS NICHOLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
9 HAYWOOD AVE, RUTLAND, VT 05701-4832
(802) 775-0007
Mailing address
24 RANDOLPH AVE # 2, RANDOLPH, VT 05060-1110
(802) 578-3084
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
072-0000243
VT
Other
Enumeration date
05/21/2009
Last updated
05/21/2009
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