Individual
JESSICA TAYLOR NICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP, TSSLD
Contact information
Practice address
5300 ANTEQUERA RD NW APT 701, ALBUQUERQUE, NM 87120-4577
(361) 249-0247
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
(505) 272-1476
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
026150
NY
235Z00000X
Speech-Language Pathologist
SLP-2023-0180
NM
Other
Enumeration date
08/12/2016
Last updated
09/26/2024
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