Individual
MRS. JOY WALTZ NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCCSLP
Contact information
Practice address
2338 REDBUD TREE DR, APEX, NC 27539-6253
(919) 244-5996
Mailing address
2338 REDBUD TREE DR, APEX, NC 27539-6253
(919) 244-5996
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8686
NC
235Z00000X
Speech-Language Pathologist
SL007735
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1011096800001
MEDICAL ASSISTANCE #
PA
05
—
7413240
—
NC
Enumeration date
03/26/2007
Last updated
10/06/2015
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