Provider Demographics
NPI:1962015016
Name:WASSING, NICOLE (AUD)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:WASSING
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 BOILING SPRINGS RD STE 1400
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-4205
Mailing Address - Country:US
Mailing Address - Phone:864-582-2900
Mailing Address - Fax:
Practice Address - Street 1:1330 BOILING SPRINGS RD STE 1400
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-4205
Practice Address - Country:US
Practice Address - Phone:864-582-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4161237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter