Provider Demographics
NPI:1225357783
Name:NICHOLLS, GAIL H
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:H
Last Name:NICHOLLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 N MERAMEC AVE
Mailing Address - Street 2:STE 110A
Mailing Address - City:CLAYTON
Mailing Address - State:MO
Mailing Address - Zip Code:63105-3750
Mailing Address - Country:US
Mailing Address - Phone:314-704-5727
Mailing Address - Fax:314-863-7545
Practice Address - Street 1:141 N MERAMEC AVE
Practice Address - Street 2:STE 110A
Practice Address - City:CLAYTON
Practice Address - State:MO
Practice Address - Zip Code:63105-3750
Practice Address - Country:US
Practice Address - Phone:314-704-5727
Practice Address - Fax:314-863-7545
Is Sole Proprietor?:No
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist