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General NPI Number Information
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NPI Number | 1710201389
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Entity Type | Individual
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Provider Name | SANDRA R NELSON SLP
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Gender | Female
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Dates
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Enumeration Date | 03/25/2010
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Last Update Date | 03/25/2010
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Provider Practice Location Address
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Address Line | 3486 STAMPER DR
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City | WINCHESTER
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State | KY
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Zip | 40391-1159
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Country | US
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Telephone | 859-351-7933
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Fax | 270-495-7065
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Provider Business Mailing Address
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Address Line | 3486 STAMPER DR
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City | WINCHESTER
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State | KY
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Zip | 40391-1159
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Country | US
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Telephone | 859-351-7933
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Fax | 270-495-7065
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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 | 0670
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License Number State | KY
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