Individual
MRS. ANDREA LAUREN NICKDOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
45 CROSSWAY E, BOHEMIA, NY 11716-1204
(631) 218-4949
(631) 567-3640
Mailing address
1 CANTERBURY DR, SAYVILLE, NY 11782-1342
(631) 567-0514
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
009266-1
NY
Other
Enumeration date
01/26/2007
Last updated
07/08/2007
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