Provider Demographics
NPI:1083973648
Name:DILLON, NICOLE LYNNE (MA/SLP-CCC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:LYNNE
Last Name:DILLON
Suffix:
Gender:F
Credentials:MA/SLP-CCC
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:LYNNE
Other - Last Name:ZIMMERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA/SLP-CCC
Mailing Address - Street 1:256A POKER RD
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:15666-5532
Mailing Address - Country:US
Mailing Address - Phone:724-493-9643
Mailing Address - Fax:
Practice Address - Street 1:5 MANORFIELD CIR
Practice Address - Street 2:
Practice Address - City:DELMONT
Practice Address - State:PA
Practice Address - Zip Code:15626-1548
Practice Address - Country:US
Practice Address - Phone:724-493-9643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-16
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010833235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist