Provider Demographics
NPI:1568001592
Name:GOLUB, NICHOL DANIELLE (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:NICHOL
Middle Name:DANIELLE
Last Name:GOLUB
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:NICHOL
Other - Middle Name:DANIELLE
Other - Last Name:CROSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CF-SLP
Mailing Address - Street 1:7108 S KANNER HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-7462
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101425 OVERSEAS HWY # 278
Practice Address - Street 2:
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037-4505
Practice Address - Country:US
Practice Address - Phone:305-587-0426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-20
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA18303235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist