Provider Demographics
NPI:1265225635
Name:VEZINA, NICOLE (OTR)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:VEZINA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 OLD FARM RD
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-3053
Mailing Address - Country:US
Mailing Address - Phone:413-887-7363
Mailing Address - Fax:
Practice Address - Street 1:24 TABOR XING
Practice Address - Street 2:
Practice Address - City:LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01106-1779
Practice Address - Country:US
Practice Address - Phone:800-633-6313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist