Provider Demographics
NPI:1801497334
Name:NICHOLS, EMILY E (OTR/L)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:E
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:LOZIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:613 SQUIRE CIR APT 101
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-6561
Mailing Address - Country:US
Mailing Address - Phone:239-293-0531
Mailing Address - Fax:
Practice Address - Street 1:613 SQUIRE CIR APT 101
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-6561
Practice Address - Country:US
Practice Address - Phone:239-293-0531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT16232225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist