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General NPI Number Information
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NPI Number | 1255224069
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Entity Type | Individual
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Provider Name | NICOLE WAUGH
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Gender | Female
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 306 W PULASKI HWY
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City | ELKTON
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State | MD
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Zip | 21921-5217
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Country | US
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Telephone | 410-686-3629
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Fax |
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Provider Business Mailing Address
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Address Line | 138 LIBORIO DR
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City | MIDDLETOWN
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State | DE
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Zip | 19709-3104
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Country | US
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Telephone | 302-276-3828
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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