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General NPI Number Information
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NPI Number | 1033047501
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Entity Type | Individual
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Provider Name | EMILY NICKLAUS MS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/13/2026
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Last Update Date | 05/13/2026
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Provider Practice Location Address
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Address Line | 304 KAPHAEM RD
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City | TOMAHAWK
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State | WI
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Zip | 54487-7800
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Country | US
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Telephone | 715-453-2141
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Fax |
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Provider Business Mailing Address
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Address Line | 2331 PORTER RD
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City | PLOVER
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State | WI
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Zip | 54467-2447
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Country | US
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Telephone | 920-901-9264
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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