Individual
MARY V. NANEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4595 E HIGHWAY 20, NICEVILLE, FL 32578-8847
(850) 374-7974
(224) 661-6475
Mailing address
5530 MIMOSA ST, CRESTVIEW, FL 32539-8999
(618) 382-4644
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA15714
FL
314000000X
Skilled Nursing Facility
Primary
057002113
IL
Other
Enumeration date
07/25/2008
Last updated
01/18/2026
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