Individual
NICOLE MARIE MCGILLICUDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2700 W HONADEL BLVD, OAK CREEK, WI 53154-2650
(414) 435-2005
Mailing address
1888 N WATER ST APT 603, MILWAUKEE, WI 53202-1569
(630) 272-8984
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5530-154
WI
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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