Individual
KELLY NOMIKOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
100 E MAIN ST APT 7, SPARTANBURG, SC 29306-5174
(864) 310-4415
(864) 310-4415
Mailing address
100 E MAIN ST APT 7, SPARTANBURG, SC 29306-5174
(864) 310-4415
(864) 310-4415
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3520
SC
Other
Enumeration date
05/04/2020
Last updated
05/04/2020
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