Individual
NICOLE LYNN BERNHOLZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3767 DELAWARE AVE, KENMORE, NY 14217-1040
(716) 864-6175
Mailing address
42 E SPRING ST APT 2A, WILLIAMSVILLE, NY 14221-5446
(716) 250-8570
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
011280
NY
Other
Enumeration date
04/03/2023
Last updated
04/03/2023
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