| Doctor Name: | NICOLE CHRISTINE ROSS |
| NPI Number: | 1871865402 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A. CF-SLP |
| License Number: | SZ5697 |
| Business Practice Address: | 6150 Diamond Centre Ct Suite 203 Fort Myers, FL - 339124365 |
| Business Phone Number: | 2394823154 |
| Business Fax Number: | |
| Mailing Address: | 1420 Reynard Dr, FORT MYERS |
| State: | FL |
| Postal Code: | 339192206 |
| Phone Number: | 7347568279 |
| Fax Number: | |
| NPI Enumeration Date: | 01/27/2012 |
| NPI Last Update Date: | 01/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SZ5697 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |