Individual
NICOLE BACAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
709 IOWA ST, SIOUX CITY, IA 51105-1945
(712) 522-2961
Mailing address
709 IOWA ST, SIOUX CITY, IA 51105-1945
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
002213
IA
Other
Enumeration date
02/19/2014
Last updated
02/19/2014
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