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Individual

NICOLE NEAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, OTR/L

Contact information

Practice address
1801 RUSTIC DR APT 105, LAPEER, MI 48446-3926
(212) 321-5113
Mailing address
4252 42ND ST SW, GRANDVILLE, MI 49418-2311
(847) 863-2582

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009479
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
355267
NBCOT
MI
01
5201009479
LICENSE
MI
Enumeration date
04/26/2016
Last updated
11/03/2025
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