Individual
MRS. NICOLE D MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
705 E TAYLOR ST, PRAIRIE DU CHIEN, WI 53821-2110
(608) 357-2000
(608) 357-2254
Mailing address
705 E TAYLOR ST, PRAIRIE DU CHIEN, WI 53821-2110
(608) 357-2000
(608) 357-2254
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1858154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42769500
—
WI
Enumeration date
01/08/2007
Last updated
07/08/2007
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