Most Relevant Information
Provider Data
| NPI Number: | 1003305004 |
| Provider Name: | NICOLE MANIGEH AHMADI OT |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: | 119142 |
Most Important Dates
| Enumeration Date: | 05/04/2018 |
| Last Updated: | 06/13/2024 |
Provider Practice Location
21630 MERCHANTS WAY STE D
KATY
TX
774492514
Practice Location Phone/Fax
| Phone: | 8322301518 |
| Fax: |
Provider Mailing Location
21630 MERCHANTS WAY STE D
KATY
TX
774492514
Provider Mailing Phone/Fax
| Phone: | 8322301518 |
| Fax: |