Individual
MRS. NICOLE M HANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
109 WIND HAVEN DR STE 100, NICHOLASVILLE, KY 40356
(859) 224-2273
(859) 224-4675
Mailing address
109 WIND HAVEN DR STE 100, NICHOLASVILLE, KY 40356-8010
(859) 224-2273
(859) 224-4675
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
135802
KY
225XP0200X
Pediatric Occupational Therapist
R5802
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000880081
ANTHEM
KY
Enumeration date
06/24/2014
Last updated
04/26/2019
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