Individual
NICOLE FOX JENNETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1304 SE SECOND ST, SNOW HILL, NC 28580-2014
(252) 747-8126
Mailing address
214 SE FOURTH ST, SNOW HILL, NC 28580-1526
(828) 773-3588
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
14109
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14109
NORTH CAROLINA BOARD OF OCCUPATIONAL THERAPY
NC
Enumeration date
06/01/2022
Last updated
06/01/2022
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