Healthcare Provider Details

I. General information

NPI: 1255657268
Provider Name (Legal Business Name): NICOLE M. PERMAN CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2010
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 RENO STREET
HAWLEY MN
56549
US

IV. Provider business mailing address

20101 14TH AVE S
HAWLEY MN
56549-9268
US

V. Phone/Fax

Practice location:
  • Phone: 218-483-5678
  • Fax:
Mailing address:
  • Phone: 605-216-0146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: