Provider Demographics
NPI:1063852879
Name:DAY, NICOLE (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:
Last Name:DAY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MRS
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:CAPUTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:15926 NOTTINGHILL DR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548-6182
Mailing Address - Country:US
Mailing Address - Phone:813-528-1714
Mailing Address - Fax:813-877-7323
Practice Address - Street 1:2916 HABANA WAY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7108
Practice Address - Country:US
Practice Address - Phone:813-877-7415
Practice Address - Fax:813-877-7323
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-26
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA15454235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist