Provider Demographics
NPI:1467698183
Name:KAPPELLER, NICOLE BIANCA (MS ED, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:BIANCA
Last Name:KAPPELLER
Suffix:
Gender:F
Credentials:MS ED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 SKYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-1427
Mailing Address - Country:US
Mailing Address - Phone:845-454-4992
Mailing Address - Fax:
Practice Address - Street 1:44 SKYVIEW DR
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-1427
Practice Address - Country:US
Practice Address - Phone:845-454-4992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-30
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014345-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist