Healthcare Provider Details

I. General information

NPI: 1265893457
Provider Name (Legal Business Name): MS. NICOLE MOREL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2016
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 SANDY CV
OCOEE FL
34761-1943
US

IV. Provider business mailing address

1240 SANDY CV
OCOEE FL
34761-1943
US

V. Phone/Fax

Practice location:
  • Phone: 202-683-0606
  • Fax:
Mailing address:
  • Phone: 202-683-0606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW23655
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: