Provider Demographics
NPI:1487835518
Name:SHAPIRO, NICOLE MARISSA
Entity Type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:MARISSA
Last Name:SHAPIRO
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 1:19 LITTLE TREE LN
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02019-2911
Mailing Address - Country:US
Mailing Address - Phone:508-883-4943
Mailing Address - Fax:
Practice Address - Street 1:19 LITTLE TREE LN
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02019-2911
Practice Address - Country:US
Practice Address - Phone:508-883-4943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist