Individual
NICOLE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
1 DIAMOND HILL RD, BERKELEY HEIGHTS, NJ 07922-2104
(973) 273-4300
Mailing address
22 CONSTANCE RD, NEW PROVIDENCE, NJ 07974-2511
(917) 373-2488
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00451200
NJ
Other
Enumeration date
01/02/2009
Last updated
09/18/2024
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