Provider Demographics
NPI:1700645413
Name:TOTO, NICOLE (MA IN EDUCATION)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:TOTO
Suffix:
Gender:F
Credentials:MA IN EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 BAY SHORE BLVD UNIT A
Mailing Address - Street 2:
Mailing Address - City:INDIAN ROCKS BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33785-2829
Mailing Address - Country:US
Mailing Address - Phone:908-938-8909
Mailing Address - Fax:
Practice Address - Street 1:1213 BAY SHORE BLVD UNIT A
Practice Address - Street 2:
Practice Address - City:INDIAN ROCKS BEACH
Practice Address - State:FL
Practice Address - Zip Code:33785-2829
Practice Address - Country:US
Practice Address - Phone:908-938-8909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-15
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL222Q00000X
NJ252Y00000X, 305S00000X
222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No252Y00000XAgenciesEarly Intervention Provider Agency
No305S00000XManaged Care OrganizationsPoint of Service