Healthcare Provider Details

I. General information

NPI: 1699794255
Provider Name (Legal Business Name): BARBARA A NICHOLS LP, SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 ELTON HILLS LN NW
ROCHESTER MN
55901-3567
US

IV. Provider business mailing address

3534 WRIGHT RD SW
ROCHESTER MN
55902-1403
US

V. Phone/Fax

Practice location:
  • Phone: 507-282-1009
  • Fax:
Mailing address:
  • Phone: 507-288-7878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLP3615
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7027
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: