Organization Name: | NICOLE G BENNETT, LLC |
NPI Number: | 1891906798 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NICOLE G BENNETT (SOLE PROPIETOR) |
Mailing Address: | 500 Barry Ave Hampton |
State: | SC US |
Postal Code: | 299243810 |
Phone Number: | 8036860377 |
Fax Number: | 8039430706 |
NPI Enumeration Date: | 05/24/2007 |
NPI Last Update Date: | 10/25/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 3187 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
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 |