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Individual

NICOLE LEE UTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2600 NE NEFF RD, BEND, OR 97701-6337
(541) 706-6843
(541) 598-3444
Mailing address
2500 NE NEFF RD, BEND, OR 97701-6015

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
WA
225X00000X
Occupational Therapist
Primary
414946
OR

Other

Enumeration date
05/24/2017
Last updated
11/18/2025
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