Provider Demographics
NPI:1477890994
Name:PASCHIS, NICOLE (OTR)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:
Last Name:PASCHIS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 EMERY DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-1279
Mailing Address - Country:US
Mailing Address - Phone:970-631-5702
Mailing Address - Fax:
Practice Address - Street 1:3128 BOXELDER DR
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-5808
Practice Address - Country:US
Practice Address - Phone:307-634-7901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-04
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0003527225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist