Individual
NICOLE BURKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
31918 US HIGHWAY 19 N, PALM HARBOR, FL 34684-3730
(727) 202-9200
Mailing address
7446 ASTOR DR, NEW PORT RICHEY, FL 34652-1208
(727) 202-9200
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT 17464
FL
Other
Enumeration date
06/09/2016
Last updated
06/09/2016
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