Organization Name: | NICOLE N THORSON, LLC |
NPI Number: | 1093074049 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NICOLE THORESON (OWNER) |
Mailing Address: | 3124 W Main St Suite 14 Dothan |
State: | AL US |
Postal Code: | 363051146 |
Phone Number: | 3346998878 |
Fax Number: | 3346995175 |
NPI Enumeration Date: | 05/11/2012 |
NPI Last Update Date: | 05/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2897 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
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 |