Individual
NICOLE WATTS NEWCOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3920 WOODLAND HEIGHTS RD, LITTLE ROCK, AR 72212-2495
(501) 227-3600
Mailing address
3920 WOODLAND HEIGHTS RD, LITTLE ROCK, AR 72212
(501) 227-3600
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1880
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150975721
—
AR
01
—
5A072
BLUE CROSS BLUE SHIELD
AR
Enumeration date
02/28/2007
Last updated
01/06/2011
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