Individual
MS. NICOLE RENE' LAFAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
11510 MAIN STREET, MIDDLETOWN, KY 40243
(502) 553-0652
(502) 409-5775
Mailing address
PO BOX 22207, LOUISVILLE, KY 40252-0207
(502) 553-0652
(502) 409-5775
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10-057
KY
Other
Enumeration date
06/24/2010
Last updated
06/24/2010
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