Doctor Name: | MRS. JENNIFER NICKEL |
NPI Number: | 1285030221 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 9858 |
Business Practice Address: | 525 W 6th St Port Clinton, OH - 434522160 |
Business Phone Number: | 4193410804 |
Business Fax Number: | 4197343705 |
Mailing Address: | Po Box 378, SANDUSKY |
State: | OH |
Postal Code: | 448710378 |
Phone Number: | 4196091112 |
Fax Number: | 4196091123 |
NPI Enumeration Date: | 11/18/2014 |
NPI Last Update Date: | 03/15/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 9858 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
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 |