Individual
NICOLE PAGANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5937 COVE RD, ROANOKE, VA 24019-2403
(540) 561-3900
Mailing address
5937 COVE RD, ROANOKE, VA 24019-2403
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
0813001033
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0813001033
VIRGINIA DEPARTMENT OF HEALTH PROFESSIONS
VA
Enumeration date
07/28/2020
Last updated
07/28/2020
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