Doctor Name: | MRS. NICOLE MALENE BOSCH |
NPI Number: | 1063856334 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | LL60338900 |
Business Practice Address: | 214 W Main Puyallup, WA - 983715328 |
Business Phone Number: | 2538418700 |
Business Fax Number: | |
Mailing Address: | 7107 141st Street Ct E, PUYALLUP |
State: | WA |
Postal Code: | 983738201 |
Phone Number: | 2535392086 |
Fax Number: | |
NPI Enumeration Date: | 04/17/2013 |
NPI Last Update Date: | 04/17/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | LL60338900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
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 |