Provider Demographics
NPI:1881229821
Name:ONAS, NICOLE YVETTE ROSALES (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NICOLE YVETTE
Middle Name:ROSALES
Last Name:ONAS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:NICOLE YVETTE
Other - Middle Name:EBALO
Other - Last Name:ROSALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6316 COYOTE VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-2006
Mailing Address - Country:US
Mailing Address - Phone:562-857-7237
Mailing Address - Fax:
Practice Address - Street 1:6316 COYOTE VALLEY CT
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-2006
Practice Address - Country:US
Practice Address - Phone:562-857-7237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21121235Z00000X
NVSP-2502235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist