Individual
MR. NICHOLAS SAMUEL EDMUNDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SLP-CCC
Contact information
Practice address
2087 10TH ST, WYANDOTTE, MI 48192-3807
(734) 225-8818
Mailing address
2087 10TH ST, WYANDOTTE, MI 48192-3807
(734) 225-8818
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101002273
MI
Other
Enumeration date
09/22/2013
Last updated
09/22/2013
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