Provider Demographics
NPI:1235402173
Name:RAPPA, NICOLE (MS)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:RAPPA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12552 DALLINGTON TER
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-6531
Mailing Address - Country:US
Mailing Address - Phone:407-718-0145
Mailing Address - Fax:407-654-8424
Practice Address - Street 1:12552 DALLINGTON TER
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-6531
Practice Address - Country:US
Practice Address - Phone:407-718-0145
Practice Address - Fax:407-654-8424
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health