Healthcare Provider Details

I. General information

NPI: 1134039415
Provider Name (Legal Business Name): OT 2 GO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 HAMILTON CHAMBERS RD
LEBANON TN
37087-7327
US

IV. Provider business mailing address

2120 HAMILTON CHAMBERS RD
LEBANON TN
37087-7327
US

V. Phone/Fax

Practice location:
  • Phone: 609-784-4294
  • Fax:
Mailing address:
  • Phone: 609-784-4294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: NICOLE VERRETT
Title or Position: OWNER
Credential: OTR-L
Phone: 609-784-4294