Individual
NICOLE DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
32150 N NORTH FOOTHILLS DR, PHOENIX, AZ 85085-8100
(623) 445-8400
Mailing address
11 E BELL RD APT 307, PHOENIX, AZ 85022-6327
(636) 368-6864
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP11612
AZ
Other
Enumeration date
01/09/2019
Last updated
01/09/2019
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