Provider Demographics
NPI:1497250633
Name:BUCCIERI-ALDRIDGE, NICOLE M (SPEECH-LANGUAGE PATH)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:M
Last Name:BUCCIERI-ALDRIDGE
Suffix:
Gender:F
Credentials:SPEECH-LANGUAGE PATH
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:729 THIMBLE SHOALS BLVD
Mailing Address - Street 2:STE 4-C
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606
Mailing Address - Country:US
Mailing Address - Phone:757-873-2932
Mailing Address - Fax:757-873-8780
Practice Address - Street 1:729 THIMBLE SHOALS BLVD
Practice Address - Street 2:STE 4-C
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606
Practice Address - Country:US
Practice Address - Phone:757-873-2932
Practice Address - Fax:757-873-8780
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA2202006157235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist