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Individual
MRS. NICOLE ROBERTS
Active
Individual
MRS. NICOLE ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
SA6885
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000279800
—
FL
05
—
887082900
—
FL
01
—
S2506
BCBS OF FLORIDA
FL
Enumeration date
11/28/2006
Last updated
11/16/2011
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