Individual
MRS. NICOLE LEE LADOUCEUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
1640 REDSTONE CENTER DR, SUITE 200, PARK CITY, UT 84098-7605
(435) 776-7203
Mailing address
806 ROSS AVE, NEW KENSINGTON, PA 15068-5726
(904) 472-7057
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
006686
OH
225X00000X
Occupational Therapist
3556
TN
225X00000X
Occupational Therapist
3875
AZ
Other
Enumeration date
04/22/2007
Last updated
09/11/2025
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