Provider Demographics
NPI:1710415534
Name:NEFF, NICHOLE R (OTR/L)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:R
Last Name:NEFF
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 DUNKEITH DR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-1933
Mailing Address - Country:US
Mailing Address - Phone:330-412-3646
Mailing Address - Fax:
Practice Address - Street 1:1325 DUNKEITH DR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-1933
Practice Address - Country:US
Practice Address - Phone:330-412-3646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT009393225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist