Provider Demographics
NPI:1346710639
Name:SCHERBARTH, NICOLE MARIE (CTRS, ATRIC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:MARIE
Last Name:SCHERBARTH
Suffix:
Gender:F
Credentials:CTRS, ATRIC
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:CASSELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1849
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48068-1849
Mailing Address - Country:US
Mailing Address - Phone:248-419-0327
Mailing Address - Fax:
Practice Address - Street 1:1715 DALLAS AVE
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-3517
Practice Address - Country:US
Practice Address - Phone:616-901-5670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist