Individual
DIANE NICOLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2133 TREEHAVEN CIR S, FORT MYERS, FL 33907-4084
(239) 278-5058
Mailing address
2133 TREEHAVEN CIR S, FORT MYERS, FL 33907-4084
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT11110
FL
Other
Enumeration date
10/12/2011
Last updated
10/12/2011
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