Nicole Halliwell, DSC, OTR/L

Individual provider Active NPI Occupational Therapist · Oldwick, NJ

NPI 1124668702 · NPPES record last updated Jan 10, 2020

Key facts

NPI
1124668702
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
46TR00594500 (NJ)
Practice address
83 Old Tpke
Oldwick, NJ 08858-7001
Phone
(908) 439-9636
NPI assigned
Jan 10, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
46TR00594500NJMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mane Stream, Inc. Past
since Jan 12, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 46TR00594500 NJ Yes

Addresses

Primary practice location

83 Old Tpke
Oldwick, NJ 08858-7001

Mailing address

PO Box 305
Oldwick, NJ 08858-0305
Phone (908) 439-9636

Other providers in Oldwick, NJ

All providers in Oldwick, NJ · Occupational Therapist in New Jersey

Sources for this page

Verify at the official NPI Registry.