Healthcare Provider Details

I. General information

NPI: 1346136363
Provider Name (Legal Business Name): NATALIE MARIE NICHOLS MS, SLP-CF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12520 PROSPERITY DR STE 220
SILVER SPRING MD
20904-1660
US

IV. Provider business mailing address

6308 SILVERY STAR PATH
COLUMBIA MD
21044-6007
US

V. Phone/Fax

Practice location:
  • Phone: 301-869-7505
  • Fax:
Mailing address:
  • Phone: 443-718-1070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number03087L
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: