Provider Demographics
NPI:1508433525
Name:RUMPF, NICOLE (MA CCC/SLP)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:RUMPF
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:MATRANGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:123 PROGRESS DR
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-2450
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:123 PROGRESS DR
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-2450
Practice Address - Country:US
Practice Address - Phone:860-509-3770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004380235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist