1568001592 NPI number — NICHOL DANIELLE GOLUB M.S., CF-SLP

Table of content: NICHOL DANIELLE GOLUB M.S., CF-SLP (NPI 1568001592)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568001592 NPI number — NICHOL DANIELLE GOLUB M.S., CF-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOLUB
Provider First Name:
NICHOL
Provider Middle Name:
DANIELLE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S., CF-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CROSE
Provider Other First Name:
NICHOL
Provider Other Middle Name:
DANIELLE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S. CF-SLP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1568001592
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7108 S KANNER HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STUART
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34997-7462
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101425 OVERSEAS HWY # 278
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KEY LARGO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33037-4505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-587-0426
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/20/2019

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: 235Z00000X , with the licence number:  18303 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com