Provider Demographics
NPI:1790066231
Name:NEWELL, NICOLE PRIEST (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:PRIEST
Last Name:NEWELL
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 1:2061 GLEN CANNON DR
Mailing Address - Street 2:
Mailing Address - City:PISGAH FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:28768-8956
Mailing Address - Country:US
Mailing Address - Phone:732-259-9622
Mailing Address - Fax:
Practice Address - Street 1:9 SUMMIT AVE
Practice Address - Street 2:B
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1938
Practice Address - Country:US
Practice Address - Phone:828-545-3556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00207600225XP0200X
NC9239225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics