Individual
NICOLE DEDERICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. CCC/SLP
Contact information
Practice address
900 GAGEL AVE, LOUISVILLE, KY 40216-4012
(502) 368-5827
Mailing address
4822 STANLEY FARM CT, LA GRANGE, KY 40031-6714
(712) 229-6819
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
140527
KY
235Z00000X
Speech-Language Pathologist
22007228A
IN
Other
Enumeration date
09/11/2013
Last updated
01/10/2025
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