Provider Demographics
NPI:1992367601
Name:BATAGOWER, NICHOLE SHANDELL (CF-SLP)
Entity Type:Individual
Prefix:MISS
First Name:NICHOLE
Middle Name:SHANDELL
Last Name:BATAGOWER
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 PINE MEADOW CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-8747
Mailing Address - Country:US
Mailing Address - Phone:713-702-6883
Mailing Address - Fax:
Practice Address - Street 1:1403 PINE MEADOW CT
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-8747
Practice Address - Country:US
Practice Address - Phone:713-702-6883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115650235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist