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Individual
MRS. NICOLE TUCKER GATHWRIGHT
Active
Individual
MRS. NICOLE TUCKER GATHWRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., C.C.C.-S.L.P.
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA 5826
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13425301
IND CITRUS ID#
FL
05
—
886461600
—
FL
01
—
SA 5826
STATE LICENSURE
FL
01
—
Y905L
BCBS FL
FL
Enumeration date
08/31/2006
Last updated
02/14/2011
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