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General NPI Number Information
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NPI Number | 1366938722
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Entity Type | Individual
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Provider Name | NICOLE WARD MA CCC SLP
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Gender | Female
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Dates
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Enumeration Date | 07/09/2018
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 133 EAYRESTOWN RD STE F
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City | SOUTHAMPTON
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State | NJ
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Zip | 08088-9122
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Country | US
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Telephone | 609-234-6545
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Fax |
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Provider Business Mailing Address
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Address Line | 14 MELVILLE DR
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City | MEDFORD
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State | NJ
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Zip | 08055-3944
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Country | US
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Telephone | 609-234-6546
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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 | 41YS00948200
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License Number State | NJ
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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 | NJ
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