Individual
NICOLE PHELPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
420 N JEFFERSON ST, KNIGHTSTOWN, IN 46148-1024
(317) 494-0233
Mailing address
420 N JEFFERSON ST, KNIGHTSTOWN, IN 46148-1024
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002561A
IN
Other
Enumeration date
12/01/2016
Last updated
12/01/2016
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