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NPI Code Detail

MEDICARE: TONIA LARITA NICHOLSON-FLOWERS

MEDICARE:   TONIA LARITA NICHOLSON-FLOWERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1598927410
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONIA LARITA NICHOLSON-FLOWERS
Provider Business Mailing Address
First Line : 3473 S KING DR
Second Line : SUITE 378
City : CHICAGO
State : IL
Zip : 60616-4108
Country : US
Telephone Number : 773-403-5836
Fax Number : 708-260-9396
Provider Business Practice Location Address
First Line : 3473 S KING DR
Second Line : SUITE 378
City : CHICAGO
State : IL
Zip : 60616-4108
Country : US
Telephone Number : 773-403-5836
Fax Number : 708-260-9396
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2008
Last Update Date : 07/01/2008

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Directions to “ TONIA LARITA NICHOLSON-FLOWERS ” Practice Location

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