Provider Demographics
NPI:1275821944
Name:NICOLE N. CHOULES, AU.D., LLC
Entity Type:Organization
Organization Name:NICOLE N. CHOULES, AU.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:CHOULES
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:801-319-2772
Mailing Address - Street 1:150 N 1100 E
Mailing Address - Street 2:UNIT 29
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780-2608
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 N 1100 E
Practice Address - Street 2:UNIT 29
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780-2608
Practice Address - Country:US
Practice Address - Phone:801-319-2772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-15
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7997609-4103231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty