Provider Demographics
NPI:1265670863
Name:MULE, NICOLE (MS CCC-SLP/TSHH)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:
Last Name:MULE
Suffix:
Gender:F
Credentials:MS CCC-SLP/TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2542 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-6233
Mailing Address - Country:US
Mailing Address - Phone:917-554-2525
Mailing Address - Fax:
Practice Address - Street 1:2542 W 2ND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-6233
Practice Address - Country:US
Practice Address - Phone:917-554-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist