MEDICARE: NICOLE MAJOR SLP

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	235Z00000X	Speech-Language Pathologist	4907	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760764039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE MAJOR SLP

Provider Business Mailing Address
First Line	:	9500 MONTGOMERY BLVD NE
Second Line	:	SUITE 215
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-2501
Country	:	US
Telephone Number	:	505-247-4224
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 MONTGOMERY BLVD NE
Second Line	:	SUITE 215
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-2501
Country	:	US
Telephone Number	:	505-247-4224
Fax Number	:

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

Provider Enumeration Date	:	09/13/2011
Last Update Date	:	10/20/2011

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Directions to “ NICOLE MAJOR SLP” Practice Location

Language	Start Address	Practice Location

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