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Individual

LAURA NICHOLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
246 MARINER BLVD, SPRING HILL, FL 34609-5691
(352) 683-2120
Mailing address
8851 CANDLEWICK LN, PORT RICHEY, FL 34668-5770

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OTA9626
FL

Other

Enumeration date
03/15/2010
Last updated
03/15/2010
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