Provider Demographics
NPI:1376212928
Name:HALL, NICOLE (SLA)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:SLA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 MILLERS FARM DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03868-8831
Mailing Address - Country:US
Mailing Address - Phone:603-285-5992
Mailing Address - Fax:
Practice Address - Street 1:105 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-2007
Practice Address - Country:US
Practice Address - Phone:603-332-2848
Practice Address - Fax:603-330-0838
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH01822355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant