MEDICARE: NICOLEILA WINTHER OTR

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
1	225X00000X	Occupational Therapist	6937	AZ

General Provider Information

NPI Number	:	1679098560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLEILA WINTHER OTR

Provider Business Mailing Address
First Line	:	18245 N PIMA RD APT 3053
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85255-6374
Country	:	US
Telephone Number	:	623-282-5628
Fax Number	:

Provider Business Practice Location Address
First Line	:	18245 N PIMA RD APT 3053
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85255-6374
Country	:	US
Telephone Number	:	623-282-5628
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2017
Last Update Date	:	07/21/2022

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