Nicole Blake-Jones

Individual provider Active NPI Occupational Therapy Assistant · Rockford, MI

NPI 1174237374 · NPPES record last updated Jan 11, 2023

Key facts

NPI
1174237374
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
Practice address
9455 Stone View Dr NE # de
Rockford, MI 49341-7471
Phone
(616) 916-0310
NPI assigned
Jan 11, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant
Group: 193400000X SINGLE SPECIALTY GROUP
224Z00000X Yes

Addresses

Primary practice location

9455 Stone View Dr NE # de
Rockford, MI 49341-7471

Mailing address

9455 Stone View Dr NE # de
Rockford, MI 49341-7471
Phone (616) 916-0310

Other providers in Rockford, MI

All providers in Rockford, MI · Occupational Therapy Assistant in Michigan

Sources for this page

Verify at the official NPI Registry.