Nicole E. Raithel
Individual provider Active NPI Speech-Language Pathologist · California, MO
NPI 1922477595 · NPPES record last updated Dec 2, 2015
Key facts
- NPI
- 1922477595
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2015030424 (MO)
- Practice address
- 101 S Owen St
California, MO 65018-1150 - Phone
- (573) 796-2161
- NPI assigned
- Sep 24, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015030424 | MO | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2015030424 | MO | Yes |
Addresses
Primary practice location
101 S Owen St
California, MO 65018-1150
Mailing address
101 S Owen St
California, MO 65018-1150
Phone (573) 796-2161
Other providers in California, MO
- Michelle Ann Nolph
- Pamida Stores Operating Co LLC
- Pamida Stores Operating Co LLC
- Breanna Rae Pruitt
- Jill Denise Smith Radkowiec
- Glenn R. Stenquist
- Cole Edward Vanderfeltz
- Donald J Vanderfeltz
- Kennedy Jean Volkart
- William Wallace
All providers in California, MO · Speech-Language Pathologist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.