Provider Demographics
NPI:1982414652
Name:STERN, NICOLE (MA SLP)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:STERN
Suffix:
Gender:F
Credentials:MA SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 PROFESSIONAL WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6581
Mailing Address - Country:US
Mailing Address - Phone:561-651-9614
Mailing Address - Fax:561-355-0343
Practice Address - Street 1:255 PROFESSIONAL WAY STE 200
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6581
Practice Address - Country:US
Practice Address - Phone:561-651-9614
Practice Address - Fax:561-355-0343
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist