Provider Demographics
NPI:1821458795
Name:CUGA, NICOLE E (OTR)
Entity Type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:E
Last Name:CUGA
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 1:6622 KELLY RD
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20187-2602
Mailing Address - Country:US
Mailing Address - Phone:541-653-3135
Mailing Address - Fax:
Practice Address - Street 1:6622 KELLY RD
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20187-2602
Practice Address - Country:US
Practice Address - Phone:541-653-3135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-04
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist