Provider Demographics
NPI:1346972650
Name:BIANCHI, NICOLE
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:
Last Name:BIANCHI
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 1:1627 STATE ROUTE 2023
Mailing Address - Street 2:
Mailing Address - City:CLIFFORD TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18421-7848
Mailing Address - Country:US
Mailing Address - Phone:570-241-5247
Mailing Address - Fax:
Practice Address - Street 1:1627 STATE ROUTE 2023
Practice Address - Street 2:
Practice Address - City:CLIFFORD TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18421-7848
Practice Address - Country:US
Practice Address - Phone:570-241-5247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician