Provider Demographics
NPI:1568546984
Name:BETH G. NICHOLSON
Entity Type:Organization
Organization Name:BETH G. NICHOLSON
Other - Org Name:HANDWORKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:GARDNER
Authorized Official - Last Name:NICHOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:OTR, CHT
Authorized Official - Phone:205-981-7167
Mailing Address - Street 1:3269 BROOK HIGHLAND TRCE
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5814
Mailing Address - Country:US
Mailing Address - Phone:205-981-7167
Mailing Address - Fax:205-298-9103
Practice Address - Street 1:3140 CAHABA HEIGHTS RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-5243
Practice Address - Country:US
Practice Address - Phone:205-383-8579
Practice Address - Fax:205-298-9103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2008-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0133225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51005522OtherBLUE CROSS
AL051507975OtherMEDICARE DME
AL51005521OtherBLUE CROSS
AL51510089OtherBLUE CROSS DME
AL51510089OtherBLUE CROSS DME