Provider Demographics
NPI:1487204764
Name:NOLAN, WESLEY
Entity type:Individual
Prefix:
First Name:WESLEY
Middle Name:
Last Name:NOLAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7766 CHATFIELD LN
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-7915
Mailing Address - Country:US
Mailing Address - Phone:410-303-7991
Mailing Address - Fax:410-379-0313
Practice Address - Street 1:7766 CHATFIELD LN
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-7915
Practice Address - Country:US
Practice Address - Phone:410-303-7991
Practice Address - Fax:410-379-0313
Is Sole Proprietor?:No
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist