Provider Demographics
NPI:1972046159
Name:NIKOLS, LORRAINE
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:NIKOLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LORRAINE
Other - Middle Name:
Other - Last Name:LEMIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:47 HOFFMAN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-2403
Mailing Address - Country:US
Mailing Address - Phone:516-775-9394
Mailing Address - Fax:
Practice Address - Street 1:47 HOFFMAN ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-2403
Practice Address - Country:US
Practice Address - Phone:516-775-9394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009176235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist