Individual
MRS. LYNN RAE NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S CCC-SLP, M. ED
Contact information
Practice address
3231 FAIRVIEW LN, SAINT LOUIS, MO 63129-1760
(314) 680-5770
Mailing address
3231 FAIRVIEW LN, SAINT LOUIS, MO 63129-1760
(314) 680-5770
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01013
MO
Other
Enumeration date
02/08/2023
Last updated
02/08/2023
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