Provider Demographics
NPI:1902178163
Name:KROB, NICOLE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:
Last Name:KROB
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 1:2063 APPLEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-7685
Mailing Address - Country:US
Mailing Address - Phone:704-296-5762
Mailing Address - Fax:
Practice Address - Street 1:2063 APPLEBROOK DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-7685
Practice Address - Country:US
Practice Address - Phone:704-296-5762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2570225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology