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General NPI Number Information
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NPI Number | 1679006126
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Entity Type | Individual
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Provider Name | NICOLE HORNEBER OTRL
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Gender | Female
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Dates
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Enumeration Date | 04/11/2017
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Last Update Date | 05/07/2024
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Provider Practice Location Address
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Address Line | 2040 CHAMBERS RD
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City | CARO
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State | MI
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Zip | 48723-9240
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Country | US
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Telephone | 989-233-6104
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Fax |
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Provider Business Mailing Address
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Address Line | 701 WILLIAMSBURG DR
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City | CARO
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State | MI
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Zip | 48723-1315
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Country | US
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Telephone | 989-233-6104
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5201009785
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License Number State | MI
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