Individual
LAUREN NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
55 S GREELEY ST, PALATINE, IL 60067-6174
(847) 963-1483
Mailing address
3541 N PONTIAC AVE, CHICAGO, IL 60634-2849
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.003371
IL
Other
Enumeration date
06/07/2011
Last updated
06/07/2011
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