Provider Demographics
NPI:1124320429
Name:ESCALERA, NICOLE KATIUSKA
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:KATIUSKA
Last Name:ESCALERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 FEDERAL ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-3252
Mailing Address - Country:US
Mailing Address - Phone:781-929-2352
Mailing Address - Fax:
Practice Address - Street 1:92 FEDERAL ST APT 2R
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-3252
Practice Address - Country:US
Practice Address - Phone:781-929-2352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor