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NICOLE PATRICE VINE-BRAUN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
31869 CHICAGO TRL, NEW CARLISLE, IN 46552-9639
(574) 654-2266
Mailing address
33927 PRAIRIE EDGE DR, NEW CARLISLE, IN 46552-8253
(317) 408-2020

Taxonomy

Speciality
Code
Description
License number
State
225XE0001X
Environmental Modification Occupational Therapist
31003762A
IN
225XG0600X
Gerontology Occupational Therapist
Primary
31003762A
IN
225XN1300X
Neurorehabilitation Occupational Therapist
31003762A
IN

Other

Enumeration date
09/26/2023
Last updated
09/26/2023
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