Provider Demographics
NPI:1083046577
Name:RIBET, NICOLE DESIREE (MT-BC)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:DESIREE
Last Name:RIBET
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2221 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39501-3355
Mailing Address - Country:US
Mailing Address - Phone:228-235-0774
Mailing Address - Fax:
Practice Address - Street 1:2221 5TH AVE
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-3355
Practice Address - Country:US
Practice Address - Phone:228-235-0774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist