| Lacy Nowicki, OTR/L | |
|
10222 74th St Ste 211, Kenosha, WI 53142-6810 | |
| (262) 925-5020 | |
| Not Available |
| Full Name | Lacy Nowicki |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist |
| Location | 10222 74th St Ste 211, Kenosha, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013507201 | NPI | - | NPPES |
| 7219-26 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | 719-26 (Wisconsin) | Primary |
| Provider Name | Advantage Physical Therapy & Sports Rehab, Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1881773463 PECOS PAC ID: 8022016336 Enrollment ID: O20061121000412 |
| Provider Name | Fox Rehabilitation Services Wi Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1518483973 PECOS PAC ID: 1658647581 Enrollment ID: O20171020002309 |
| Mailing Address | Practice Location Address |
|---|---|
| Lacy Nowicki, OTR/L 2550 W Tyvola Rd Ste 350, Charlotte, NC 28217-4574 Ph: (419) 221-3004 | Lacy Nowicki, OTR/L 10222 74th St Ste 211, Kenosha, WI 53142-6810 Ph: (262) 925-5020 |
Richa Kamble, Occupational Therapist Medicare: Medicare Enrolled Practice Location: 5060 Green Bay Rd, Kenosha, WI 53144 Phone: 262-825-0912 | |
Ana Jones, OTR Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 1406 91st St Apt 103, Kenosha, WI 53143 Phone: 262-331-3414 | |
Ms. Jane E Meyers, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 4103 60th St, Kenosha, WI 53144 Phone: 262-652-1111 Fax: 262-652-1124 | |
Rachel Lauren Cole, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3100 Washington Rd, Kenosha, WI 53144 Phone: 248-930-4737 | |
Mrs. Silvana K Leone, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 6308 8th Ave, Kenosha, WI 53143 Phone: 262-656-3299 | |
Mrs. Jill Marie Fonk, MS, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3100 Washington Rd, Kenosha, WI 53144 Phone: 262-658-4074 |