1346435260 NPI number — MS. NICOLE MICHELLE METZLER LCSW

Table of content: MS. NICOLE MICHELLE METZLER LCSW (NPI 1346435260)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346435260 NPI number — MS. NICOLE MICHELLE METZLER LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
METZLER
Provider First Name:
NICOLE
Provider Middle Name:
MICHELLE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346435260
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/12/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PSC 41 BOX 4055
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AE
Provider Business Mailing Address Postal Code:
09464-0041
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440117900784529
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
48 MDG/SGHC
Provider Second Line Business Practice Location Address:
UNIT 5115
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AE
Provider Business Practice Location Address Postal Code:
09461-5115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440111638528124
Provider Business Practice Location Address Fax Number:
440111638528022
Provider Enumeration Date:
09/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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