Healthcare Provider Details

I. General information

NPI: 1871423046
Provider Name (Legal Business Name): MOLLY NICOLET
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W23597 US HIGHWAY 10
STRUM WI
54770-8609
US

IV. Provider business mailing address

W21036 COUNTY ROAD H
STRUM WI
54770-7897
US

V. Phone/Fax

Practice location:
  • Phone: 715-695-2696
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: