Provider Demographics
NPI:1770250995
Name:KENT, NICOLE MARIE (ATR)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:MARIE
Last Name:KENT
Suffix:
Gender:F
Credentials:ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6293 US HIGHWAY 6
Mailing Address - Street 2:
Mailing Address - City:LINESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16424-5923
Mailing Address - Country:US
Mailing Address - Phone:716-572-2512
Mailing Address - Fax:
Practice Address - Street 1:1116 W 7TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-1104
Practice Address - Country:US
Practice Address - Phone:814-461-5617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health