Individual ProviderNicole StanzialeSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address1611 Headway Cir Bldg 2, Austin, TX 78754-5165(512) 478-2581PECOS EnrollmentBased on the most recent information from CMS, provider Nicole Stanziale does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1720313810Provider TypeIndividualFull NameStanziale, NicoleCredentialM.A. CCC-SLPGenderFemaleSole ProprietorNoEnumeration Date10/7/2009Last Updated3/14/2011Contact InformationPractice LocationPractice Address1611 Headway Cir Bldg 2, Austin, TX 78754-5165Phone(512) 478-2581FaxUnlisted FaxMailing LocationMailing Address1611 Headway Cir, Austin, TX 78754-5160PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense103276Texas