Individual
JAMIE NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
1680 SPRING CREEK RD, MACUNGIE, PA 18062-9742
(610) 530-2636
Mailing address
1680 SPRING CREEK RD, MACUNGIE, PA 18062-9742
(610) 530-2636
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL010334
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
05/17/2010
Last updated
03/17/2018
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