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

Nicole Marie Moore Perullo, MSCCC-SLP

Individual provider Speech-Language Pathologist · NPI 1518787886

Nicole Marie Moore Perullo, MSCCC-SLP is a Speech-Language Pathologist in Bend, Oregon. Practices as a sole proprietor. Licensed in Oregon.

Licensed in
OR
In the registry since
2024

Practice location Address checks out

2248 NW Lemhi Pass Dr
Bend, OR 97703-6701
Phone: (415) 497-8150
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 17418 (OR)

Record details

NPI number1518787886
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSCCC-SLP
Sole proprietorYes
NPI enumeratedOctober 11, 2024
Last updated in NPPESOctober 11, 2024
Certification dateOctober 11, 2024

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