Fornalski, Nicole M

Fornalski, Nicole M is an individual health care provider with primary practice located at 480 Medical Center Dr , Columbus OH 43210-1229. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Rehabilitation. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is her primary health care specialty. Fornalski, Nicole M can be contacted via phone (614) 293-7604.

Contact Information

Primary practice address
480 Medical Center Dr Columbus OH 43210-1229
Phone: (614) 293-7604
Fax: (614) 293-3809
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X P.08416 Ohio
Behavioral Health & Social Service Providers / Rehabilitation 103TR0400X P.08416 Ohio

Profile Details

NPI number 1942909817
LBN Legal business name Fornalski, Nicole M
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2023
Last updated May 16th, 2023 - about 2 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 1942909817 NPPES
Ohio MEDICAID 0015860

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