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General NPI Number Information
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NPI Number | 1477232197
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Entity Type | Individual
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Provider Name | NICOLE ORAMA OTA
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Gender | Female
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 500 J CLYDE MORRIS BLVD
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City | NEWPORT NEWS
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State | VA
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Zip | 23601-1929
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Country | US
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Telephone | 757-534-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 2275 WOLF ST UNIT B
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-4444
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Country | US
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Telephone | 860-550-4891
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 0131002847
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License Number State | VA
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