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General NPI Number Information
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NPI Number | 1427397728
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Entity Type | Individual
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Provider Name | NICOLE WILSON-RABBANI OTR/L
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Gender | Female
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Dates
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Enumeration Date | 02/06/2013
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Last Update Date | 02/06/2013
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Provider Practice Location Address
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Address Line | 4115 16TH ST NW
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City | WASHINGTON
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State | DC
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Zip | 20011-7003
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Country | US
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Telephone | 707-704-3165
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 IRVING ST NW APT 711
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City | WASHINGTON
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State | DC
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Zip | 20010-2850
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Country | US
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Telephone | 707-704-3165
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT010000711
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License Number State | DC
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