Individual
MRS. MELISSA MARIE NICKESRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
360 MERRIMACK ST, BLDG 9, LAWRENCE, MA 01843-1740
(978) 552-4000
Mailing address
41 DICKSON AVE, TEWKSBURY, MA 01876-1601
(978) 551-1661
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
1929
NH
225X00000X
Occupational Therapist
Primary
4036
MA
Other
Enumeration date
05/02/2011
Last updated
05/02/2011
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