Provider Demographics
NPI:1386132009
Name:PRICE, NICHOLE (MSM, QMHS)
Entity type:Individual
Prefix:
First Name:NICHOLE
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:MSM, QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CHAGRIN
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:440-606-6078
Mailing Address - Fax:
Practice Address - Street 1:28049 HARVARD ROAD
Practice Address - Street 2:
Practice Address - City:ORANGE VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:216-324-2809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-27
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program