Provider Demographics
NPI:1871732792
Name:MAYER, NICOLE YVETTE (AUD CCC-A)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:YVETTE
Last Name:MAYER
Suffix:
Gender:F
Credentials:AUD CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13422 PECK DR
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-1328
Mailing Address - Country:US
Mailing Address - Phone:586-822-9042
Mailing Address - Fax:
Practice Address - Street 1:13422 PECK DR
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-1328
Practice Address - Country:US
Practice Address - Phone:586-822-9042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI16010000526231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist