Individual
HEIDI NICKLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS.CCCSLP
Contact information
Practice address
2873 STATE ST, RIDGWAY, PA 15853-7625
(814) 834-4109
Mailing address
2873 STATE ST, RIDGWAY, PA 15853-7625
(814) 834-4109
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
SL005715L
PA
235Z00000X
Speech-Language Pathologist
Primary
SL008708
PA
Other
Enumeration date
01/29/2007
Last updated
11/30/2021
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