Provider Demographics
NPI:1447643119
Name:JAMES-PIETERS, NICOLE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:JAMES-PIETERS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 NORWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-4317
Mailing Address - Country:US
Mailing Address - Phone:908-754-7587
Mailing Address - Fax:
Practice Address - Street 1:36 S MARTINE AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FANWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07023-1221
Practice Address - Country:US
Practice Address - Phone:908-472-5290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00457700235Z00000X
NY010012235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist