National Provider Identifier
Nicole Slack
Nicole Slack is listed in the NPPES registry with a primary specialty of Developmental Therapist in Rochester, NY and a listed phone number of (585) 697-1557.
Profile Overview
- NPI
- 1821735440
- Provider Type
- Individual
- Primary Specialty
- Developmental Therapist
- Enumeration Date
- May 16, 2022
- Last Updated
- May 16, 2022
Practice Location
- 175 N Winton RD
- Rochester, NY 14610-1936
Phone: (585) 697-1557
Specialties
- Developmental Therapist (222Q00000X)
Full Record
- NPI
- 1821735440
- Entity Type
- Individual
- Last Name
- Slack
- First Name
- Nicole
- Mailing Street Address
- 175 N Winton RD
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14610-1936
- Mailing Country
- US
- Mailing Phone
- (585) 697-1557
- Practice Street Address
- 175 N Winton RD
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14610-1936
- Practice Country
- US
- Practice Phone
- (585) 697-1557
- Enumeration Date
- May 16, 2022
- Last Updated
- May 16, 2022
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- May 16, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Developmental Therapist (222Q00000X)