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General NPI Number Information
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NPI Number | 1275234247
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Entity Type | Organization
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Legal Business Name | ICON SPEECH & LANGUAGE THERAPY
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Dates
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Enumeration Date | 03/15/2023
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 1703 LAKESIDE DR
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City | RENO
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State | NV
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Zip | 89509-3409
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Country | US
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Telephone | 775-233-5773
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Fax |
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Provider Business Mailing Address
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Address Line | 500 W PLUMB LN STE B173
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City | RENO
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State | NV
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Zip | 89509-3796
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Country | US
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Telephone | 775-464-1281
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Fax | 775-464-1415
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Authorized Official
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Title or Position | OWNER
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Name | MS. NICOLE MURPHY
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Credential | M.S., CCC-SLP
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Telephone | 775-233-5773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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