Basic Information
| Provider Information | |||||||||
| NPI: | 1598130528 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRENZA NIMRICHTER | ||||||||
| FirstName: | NICOLE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | M.A. CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1860 MELVILLE CIR | ||||||||
| Address2: | |||||||||
| City: | BRUNSWICK | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442124244 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135942046 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5868 STUMPH RD | ||||||||
| Address2: | |||||||||
| City: | PARMA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441301736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4408885407 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/02/2015 | ||||||||
| LastUpdateDate: | 04/13/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.