Provider Demographics
NPI:1053867531
Name:LECHMAN, NICOLE (COTA/L)
Entity type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:
Last Name:LECHMAN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MRS
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:STARIHA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:COTA/L
Mailing Address - Street 1:PO BOX 518
Mailing Address - Street 2:
Mailing Address - City:GRANT
Mailing Address - State:MI
Mailing Address - Zip Code:49327-0518
Mailing Address - Country:US
Mailing Address - Phone:616-259-5675
Mailing Address - Fax:616-965-2473
Practice Address - Street 1:709 W SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:MI
Practice Address - Zip Code:49348-1226
Practice Address - Country:US
Practice Address - Phone:269-792-4440
Practice Address - Fax:616-965-2475
Is Sole Proprietor?:No
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5202008136224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant