Individual
NICOLE TULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00567000
NJ
225X00000X
Occupational Therapist
OC012017
PA
Other
Enumeration date
09/14/2011
Last updated
05/18/2015
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