Doctor Name: | MRS. NICOLE JORDAN WALLING |
NPI Number: | 1063672616 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A, CCC-SLP |
License Number: | 19066 |
Business Practice Address: | 1714 Meirwoods Dr Spring, TX - 773798454 |
Business Phone Number: | 7138193275 |
Business Fax Number: | 2813796041 |
Mailing Address: | 1714 Meirwoods Dr, SPRING |
State: | TX |
Postal Code: | 773798454 |
Phone Number: | 7138193275 |
Fax Number: | 2813796041 |
NPI Enumeration Date: | 06/16/2008 |
NPI Last Update Date: | 06/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 19066 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |