Individual
MRS. WILSON NICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
409 N CALIFORNIA ST, SOCORRO, NM 87801-4208
(505) 907-1902
(833) 448-2997
Mailing address
409 N CALIFORNIA ST, SOCORRO, NM 87801-4208
(505) 907-1902
(833) 448-2997
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
15254
NC
235Z00000X
Speech-Language Pathologist
Primary
5194
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03260720002-GRT
—
NM
05
—
1184855181
—
NC
Enumeration date
03/23/2011
Last updated
12/05/2023
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