Provider Demographics
NPI:1770151730
Name:ORLANDI, NICOLE MARIE (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:MARIE
Last Name:ORLANDI
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:RIDLEY PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19078-3303
Mailing Address - Country:US
Mailing Address - Phone:856-745-1528
Mailing Address - Fax:
Practice Address - Street 1:411 HARRISON ST
Practice Address - Street 2:
Practice Address - City:RIDLEY PARK
Practice Address - State:PA
Practice Address - Zip Code:19078-3303
Practice Address - Country:US
Practice Address - Phone:856-745-1528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2020101762235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist