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General NPI Number Information
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NPI Number | 1467834176
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Entity Type | Individual
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Provider Name | NICOLE GAWEL LM
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Gender | Female
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Dates
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Enumeration Date | 06/18/2015
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 18921 HOLLYBERRY DR
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City | MACOMB
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State | MI
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Zip | 48042-1835
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Country | US
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Telephone | 248-513-0929
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Fax |
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Provider Business Mailing Address
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Address Line | 15369 BRIARCREST CIR
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City | FORT MYERS
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State | FL
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Zip | 33912-6398
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Country | US
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Telephone | 239-887-0811
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Fax | 239-288-2507
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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 | 176B00000X
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Taxonomy Name | Midwife
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License Number | MW481
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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 |
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License Number State |
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