Doctor Name: | NICOLE LYNN CARLSON |
NPI Number: | 1699089276 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MHS, CCC-SLP |
License Number: | 22005059A |
Business Practice Address: | 9594 Lee Pl Crown Point, IN - 463077458 |
Business Phone Number: | 2193846295 |
Business Fax Number: | 2193655857 |
Mailing Address: | 9594 Lee Pl, CROWN POINT |
State: | IN |
Postal Code: | 463077458 |
Phone Number: | 2193846295 |
Fax Number: | 2193655857 |
NPI Enumeration Date: | 08/05/2010 |
NPI Last Update Date: | 08/05/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 22005059A |
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 |