Provider Demographics
NPI:1215337878
Name:MOORE-BINDER, NICHOLE
Entity type:Individual
Prefix:
First Name:NICHOLE
Middle Name:
Last Name:MOORE-BINDER
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 1:12947 SPENCER RD
Mailing Address - Street 2:
Mailing Address - City:HEMLOCK
Mailing Address - State:MI
Mailing Address - Zip Code:48626-9725
Mailing Address - Country:US
Mailing Address - Phone:989-245-7494
Mailing Address - Fax:
Practice Address - Street 1:3687 TAMPA RD
Practice Address - Street 2:SUITE 200
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-6307
Practice Address - Country:US
Practice Address - Phone:800-659-1522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-01
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist