| Provider / Organization | NPI | Date Certified |
|---|---|---|
| SUSAN MARIE NICOLSON | 1225187354 | 2023-11-10 |
Susan M Nicolson [F] graduated in 1989 and primarily specializes in Occupational Therapy.
Susan Marie Nicolson is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1225187354. Registration indicates Susan Marie Nicolson is a provider of services with a specialization in Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Occupational Therapist (Occupational Therapist, ) (Speech/Occupational/Physical Therapy/Chiropractor, ) (Occupational Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers)
| PECOS ID | 4284795766 |
| Entity Type | Individual |
| Provider Name | Ms. Susan Marie Nicolson OTRL |
| Practice Office Address | 6324 FAIRVIEW RD STE 202 CHARLOTTE, NC US |
| Practice Office Telephone | 9803029740 |
| Practice Office Fax | 9803029750 |
| Mailing Address | 4601 PARK RD SUITE 300 CHARLOTTE, NC 282093239 US |
| Business Telephone | 7043232090 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 6324 Fairview Rd Ste 202 | Charlotte, NC 282103361 | 9803029740 / 9803029750 |
| Code | Practice | License No State |
|---|---|---|
| 225X00000X PRIMARY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Occupational Therapist Occupational Therapist Speech/Occupational/Physical Therapy/Chiropractor Occupational Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers | 849
NC |