Individual
NICHOLE BAGWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
27 E MAIN ST, LITTLE FALLS, NJ 07424-5603
(551) 247-1306
Mailing address
12 FAIRFAX DR, LIVINGSTON, NJ 07039-2836
(973) 462-5506
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TL-3577
NJ
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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