Provider Demographics
NPI:1942767397
Name:COCCIA, NICHOLE LYNN (M ED BSL)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:LYNN
Last Name:COCCIA
Suffix:
Gender:F
Credentials:M ED BSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 PENN ST FL 2
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19601-3543
Mailing Address - Country:US
Mailing Address - Phone:610-373-4281
Mailing Address - Fax:
Practice Address - Street 1:645 PENN ST FL 2
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3543
Practice Address - Country:US
Practice Address - Phone:610-373-4281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-21
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor