Individual
JENNIFER NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
15855 WELLS HWY, SENECA, SC 29678-1078
(864) 661-2975
Mailing address
517 IVY SPRING CT, SENECA, SC 29678-5750
(864) 710-5972
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3289
SC
Other
Enumeration date
07/20/2023
Last updated
07/20/2023
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