Provider Demographics
NPI:1770185738
Name:WEBBER, NICOLE F (LMT)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:F
Last Name:WEBBER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 STOWE AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-6056
Mailing Address - Country:US
Mailing Address - Phone:914-319-7422
Mailing Address - Fax:
Practice Address - Street 1:72 STOWE AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-6056
Practice Address - Country:US
Practice Address - Phone:914-319-7422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT008564225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist