Individual
DENISE NIELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
77 NEALY AVENUE, 633D MEDICAL GROUP, JOINT BASE LANGLEY-EUSTIS, VA 23365-2040
(757) 225-7630
Mailing address
77 NEALY AVE, HAMPTON, VA 23665-2040
(757) 225-9816
(757) 764-2406
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202004457
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09136101
ASHA
—
Enumeration date
10/23/2012
Last updated
03/26/2026
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