Doctor Name: | NICOLE MEDFORD-LADD |
NPI Number: | 1326304627 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 1397 |
Business Practice Address: | 7361 Prairie Falcon Rd Ste 130 Las Vegas, NV - 891280823 |
Business Phone Number: | 7028041511 |
Business Fax Number: | 7028042551 |
Mailing Address: | 7361 Prairie Falcon Rd, Ste 130 LAS VEGAS |
State: | NV |
Postal Code: | 891280823 |
Phone Number: | 7028041511 |
Fax Number: | 7028042551 |
NPI Enumeration Date: | 04/11/2012 |
NPI Last Update Date: | 04/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 1397 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NV |
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 |