Doctor Name: | MRS. AMBER MICHELLE NICKERSON |
NPI Number: | 1487717070 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CF SLP |
License Number: | 8119 |
Business Practice Address: | 1000 S Columbia Rd Grand Forks, ND - 582014036 |
Business Phone Number: | 7017805345 |
Business Fax Number: | 7017801942 |
Mailing Address: | Po Box 6002, GRAND FORKS |
State: | ND |
Postal Code: | 582066002 |
Phone Number: | 7017805345 |
Fax Number: | 7017801942 |
NPI Enumeration Date: | 12/18/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 8119 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
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 |