National Provider Identifier

Nicole M. Wilson, C.O.T.A.

Nicole M. Wilson, C.O.T.A. is listed in the NPPES registry with a primary specialty of Occupational Therapy Assistant in Grand Island, NY and a listed phone number of (716) 773-4323.

NPI 1790093748Grand Island, NYOccupational Therapy Assistant

Profile Overview

NPI
1790093748
Provider Type
Individual
Primary Specialty
Occupational Therapy Assistant
Enumeration Date
September 23, 2010
Last Updated
September 23, 2010

Practice Location

  • 1801 Grand Island Blvd
  • Grand Island, NY 14072-2171

Phone: (716) 773-4323

Mailing Address

  • 448 Ashford Ave
  • Tonawanda, NY 14150-7002

Specialties

  • Occupational Therapy Assistant (224Z00000X)
Full Record
NPI
1790093748
Entity Type
Individual
Last Name
Wilson
First Name
Nicole
Middle Name
M.
Name Prefix
Mrs.
Credential
C.O.T.A.
Mailing Street Address
448 Ashford Ave
Mailing City
Tonawanda
Mailing State
NY
Mailing ZIP Code
14150-7002
Mailing Country
US
Mailing Phone
(716) 773-4323
Practice Street Address
1801 Grand Island Blvd
Practice City
Grand Island
Practice State
NY
Practice ZIP Code
14072-2171
Practice Country
US
Practice Phone
(716) 773-4323
Enumeration Date
September 23, 2010
Last Updated
September 23, 2010
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Occupational Therapy Assistant (224Z00000X)