Individual
MS. CORA SUE NICKEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
12045 SE STANLEY AVE, MILWAUKIE, OR 97222-2938
(503) 659-2323
Mailing address
17425 WAKE ROBIN CIR, OREGON CITY, OR 97045-4504
(503) 742-9931
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
497990
OR
Other
Enumeration date
07/17/2007
Last updated
07/17/2007
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