Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Nicole Carrillo, CCC

Individual provider Speech-Language Pathologist · NPI 1366863995

Mrs. Nicole Carrillo, CCC is a Speech-Language Pathologist in Grain Valley, Missouri. Licensed in Missouri. Registered with an NPI since 2013.

Licensed in
MO
In the registry since
2013
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Practice location Address checks out

640 NW Jefferson St
Grain Valley, MO 64029-8278
Phone: (816) 785-2284
Fax: (816) 633-4371
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 2013013585 (MO)

Record details

NPI number1366863995
Entity typeIndividual (Type 1)
GenderFemale
Credentials CCC
Sole proprietorNo
NPI enumeratedDecember 28, 2013
Last updated in NPPESDecember 28, 2013

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