Individual
MRS. NICOLE BRIANA FUQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
851 PROFESSIONAL PARK DR, CLARKSVILLE, TN 37040-5257
(931) 542-2168
Mailing address
1007 RIDGEVIEW DR, PLEASANT VIEW, TN 37146-7022
(718) 702-5464
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6525
TN
Other
Enumeration date
07/16/2013
Last updated
10/11/2022
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