Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
NICOLE LEE GOULDRUP, COTA/L
Active Sole ProprietorNICOLE LEE GOULDRUP, COTA/L is a Occupational Therapy Assistant healthcare provider located in WESTPORT, Massachusetts. NPI 1679028112 is currently active in the NPPES registry. Verify at CMS.
Occupational Therapy Assistant · WESTPORT, MA
Registration Details
- NPI Number
- 1679028112
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 24, 2016 (9.9636232431197 yrs)
- Last Updated
- Aug 24, 2016
- License
-
OTA00842 (RI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
378 HORSENECK RDWESTPORT, MA, 027901337Browse MA providers · Browse ZIP 02790
- Phone
- 5084930188
- Primary Specialty
-
Occupational Therapy Assistant
224Z00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.