Provider Demographics
NPI:1336416981
Name:PAPPO, NICOLE MARINA (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:MARINA
Last Name:PAPPO
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3536 LINDEN AVE UNIT 7
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-5601
Mailing Address - Country:US
Mailing Address - Phone:310-930-7491
Mailing Address - Fax:
Practice Address - Street 1:3536 LINDEN AVE UNIT 7
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-5601
Practice Address - Country:US
Practice Address - Phone:310-930-7491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18817235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist