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Individual

NICOLE ETHRIDGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
110 PIPEMAKERS CIR STE 115, POOLER, GA 31322-4168
(912) 988-1526
(912) 988-1537
Mailing address
110 PIPEMAKERS CIR STE 115, POOLER, GA 31322-4168
(912) 988-1526
(912) 988-1537

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
120148
TX
235Z00000X
Speech-Language Pathologist
Primary
SLP013955
GA

Other

Enumeration date
03/22/2024
Last updated
02/03/2026
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