Individual
NICOLE CHURCHILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1107 MABBETTE ST, KISSIMMEE, FL 34741-5161
(407) 201-8079
Mailing address
4115 S SEMORAN BLVD APT 9, ORLANDO, FL 32822-2427
(561) 410-3896
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SI4844
FL
Other
Enumeration date
01/27/2022
Last updated
02/10/2022
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