Provider Demographics
NPI:1093777963
Name:CWIKLIN, NANCY E (MS, OTR)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:E
Last Name:CWIKLIN
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2809 OUTRIGGER WAY
Mailing Address - Street 2:
Mailing Address - City:FT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-6705
Mailing Address - Country:US
Mailing Address - Phone:970-484-8413
Mailing Address - Fax:970-493-8016
Practice Address - Street 1:1045 ROBERTSON ST
Practice Address - Street 2:
Practice Address - City:FT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3926
Practice Address - Country:US
Practice Address - Phone:970-493-6667
Practice Address - Fax:970-493-8016
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1041871225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist