Provider Demographics
NPI:1528826906
Name:BULMAN, NICOLE RENE (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:RENE
Last Name:BULMAN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MRS
Other - First Name:NICOLE
Other - Middle Name:RENE
Other - Last Name:BULMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NICOLE RENE HENDRIX
Mailing Address - Street 1:45 KRISTINE LN
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01832-8817
Mailing Address - Country:US
Mailing Address - Phone:978-257-6407
Mailing Address - Fax:
Practice Address - Street 1:45 KRISTINE LN
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01832-8817
Practice Address - Country:US
Practice Address - Phone:978-257-6407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2726224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant