Individual
MRS. HEATHER ANNE NICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MCD
Contact information
Practice address
112 MOONTIDE CT, LEXINGTON, SC 29072-7640
(803) 796-5373
Mailing address
112 MOONTIDE CT, LEXINGTON, SC 29072-7640
(803) 796-5373
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4970
SC
Other
Enumeration date
09/21/2011
Last updated
09/21/2011
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