Lackmann, Nichole

Lackmann, Nichole is an individual health care provider with primary practice located at 602 Vonderburg Dr Suite 201, Brandon FL 33511-5900. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist, Speech, Language and Hearing Service Providers / Speech-Language Pathologist. Speech, Language and Hearing Service Providers / Speech-Language Pathologist is her primary health care specialty. Lackmann, Nichole can be contacted via phone (813) 653-1149.

Contact Information

Primary practice address
602 Vonderburg Dr Suite 201 Brandon FL 33511-5900
Phone: (813) 653-1149
Fax: (813) 654-6644
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SZ6133 Florida

Profile Details

NPI number 1437497690
LBN Legal business name Lackmann, Nichole
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2013
Last updated Mar 9th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437497690 NPPES
Florida MEDICAID 008196900
Florida MEDICAID 014439900

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