Provider Demographics
NPI:1679608129
Name:PREEPER, NICHOLE MARIE (CLINICAL INTERN)
Entity type:Individual
Prefix:MRS
First Name:NICHOLE
Middle Name:MARIE
Last Name:PREEPER
Suffix:
Gender:F
Credentials:CLINICAL INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-8114
Mailing Address - Country:US
Mailing Address - Phone:978-665-2976
Mailing Address - Fax:978-665-2980
Practice Address - Street 1:270 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-8114
Practice Address - Country:US
Practice Address - Phone:978-665-2976
Practice Address - Fax:978-665-2980
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor