Provider Demographics
NPI:1902062961
Name:HARRINGTON, NICOLE M (MS, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:M
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 MARIE ANTOINETTE ST
Mailing Address - Street 2:#402
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-6259
Mailing Address - Country:US
Mailing Address - Phone:337-258-8726
Mailing Address - Fax:
Practice Address - Street 1:655 MARIE ANTOINETTE ST
Practice Address - Street 2:#402
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-6259
Practice Address - Country:US
Practice Address - Phone:337-258-8726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5646235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist