Doctor Name: | MR. JAMES MICHAEL NELSON |
NPI Number: | 1417029927 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A., CCC-SLP |
License Number: | 22003722A |
Business Practice Address: | 415 Mission Hill Dr Fort Wayne, IN - 468046425 |
Business Phone Number: | 2604312651 |
Business Fax Number: | |
Mailing Address: | 609 Three Rivers N, FORT WAYNE |
State: | IN |
Postal Code: | 468021306 |
Phone Number: | 2604268460 |
Fax Number: | |
NPI Enumeration Date: | 11/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 22003722A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
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 |