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NPI Code Detail

MEDICARE: MS. NIKI LYNN LAND M.S., CCC-SLP

MEDICARE: MS. NIKI LYNN LAND M.S., CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist100223TX

General Provider Information

NPI Number : 1023136421
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NIKI LYNN LAND M.S., CCC-SLP
Provider Business Mailing Address
First Line : 5701 AVENUE C
Second Line :
City : AUSTIN
State : TX
Zip : 78752-4501
Country : US
Telephone Number : 512-576-4326
Fax Number : 512-420-0425
Provider Business Practice Location Address
First Line : 2011 W KOENIG LN
Second Line :
City : AUSTIN
State : TX
Zip : 78756-1131
Country : US
Telephone Number : 512-467-7006
Fax Number : 512-467-7025
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2007
Last Update Date : 09/29/2010

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Directions to “ MS. NIKI LYNN LAND M.S., CCC-SLP” Practice Location

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