Provider Demographics
NPI:1922060102
Name:MILLS, NICOLE E (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:E
Last Name:MILLS
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 1:204 E SOUTH ST
Mailing Address - Street 2:APT. #2056
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-3547
Mailing Address - Country:US
Mailing Address - Phone:407-340-6638
Mailing Address - Fax:407-523-7187
Practice Address - Street 1:204 E SOUTH ST
Practice Address - Street 2:APT. #2056
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-3547
Practice Address - Country:US
Practice Address - Phone:407-340-6638
Practice Address - Fax:407-523-7187
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11547225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist