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General NPI Number Information
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NPI Number | 1336003383
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Entity Type | Individual
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Provider Name | NYCOLE KAUK PHD
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Gender | Female
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Dates
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Enumeration Date | 12/15/2025
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 34715 ORANGE BELT DR
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City | DADE CITY
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State | FL
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Zip | 33523-6484
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Country | US
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Telephone | 727-331-2388
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Fax |
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Provider Business Mailing Address
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Address Line | 30929 MIRADA BLVD # 940
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City | SAN ANTONIO
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State | FL
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Zip | 33576-7306
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Country | US
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Telephone | 727-331-2388
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BACB473975
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | LBA2444
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY12910
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License Number State | FL
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