Provider Demographics
NPI:1568819886
Name:KIRCHER, NICOLE
Entity Type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:
Last Name:KIRCHER
Suffix:
Gender:M
Credentials:
Other - Prefix:MISS
Other - First Name:NICOLE
Other - Middle Name:ANN
Other - Last Name:KIRCHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BA
Mailing Address - Street 1:757 STERLING SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828
Mailing Address - Country:US
Mailing Address - Phone:561-797-3715
Mailing Address - Fax:
Practice Address - Street 1:757 STERLING SPRINGS RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828
Practice Address - Country:US
Practice Address - Phone:561-797-3715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst