MEDICARE: NICOLE WANDA ALAIMO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1104090638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE WANDA ALAIMO

Provider Business Mailing Address
First Line	:	418 W 7TH ST
Second Line	:
City	:	COLUMBIA
State	:	TN
Zip	:	38401-3135
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	418 W 7TH ST
Second Line	:
City	:	COLUMBIA
State	:	TN
Zip	:	38401-3135
Country	:	US
Telephone Number	:	931-388-0078
Fax Number	:	931-388-0866

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2008
Last Update Date	:	04/16/2008

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Directions to “ NICOLE WANDA ALAIMO ” Practice Location

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