Individual
NICOLE M SEBASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSCCC-SLP
Contact information
Practice address
900 E BROADWAY AVENUE, BISMARCK, ND 58501
(701) 530-7000
(701) 530-8842
Mailing address
900 E BROADWAY AVENUE, PO BOX 997, BISMARCK, ND 58502-0997
(701) 530-7000
(701) 530-8842
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
605
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
605
LICENSE
ND
Enumeration date
11/07/2007
Last updated
11/07/2007
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