Individual
NICOLE VAN DYCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-1000
Mailing address
7015 EDGEWOOD CT, SPRING GROVE, IL 60081-8335
(815) 353-0068
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
242.003895
IL
235Z00000X
Speech-Language Pathologist
Primary
5023
WI
Other
Enumeration date
06/09/2016
Last updated
04/26/2021
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