Jeannise Marie Nichols, OT

NPI #1124709498 in Draper, Utah

Provider Information

NPI Number: 1124709498
Entity Type: Individual
Name: Jeannise Marie Nichols, OT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Occupational Therapist
Credential: OT
Enumeration Date: Jul 28, 2023
Last Updated: Jul 28, 2023

Practice Location

Address: 2021 E VILLAGE GREEN CIR STE C
City: Draper
State: Utah
ZIP Code: 84020-5500
Phone: (801) 440-5592

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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