Provider Demographics
NPI:1013655596
Name:PATE, NICOLE GRACE (BEHAVIOR TECHNICIAN)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:GRACE
Last Name:PATE
Suffix:
Gender:F
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18401 TIMBER FOREST DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-2535
Mailing Address - Country:US
Mailing Address - Phone:281-852-0501
Mailing Address - Fax:
Practice Address - Street 1:18401 TIMBER FOREST DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-2535
Practice Address - Country:US
Practice Address - Phone:281-852-0501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician