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NPI Code Detail

MEDICARE: NICOLE GAIL WEDESKY M.S. CCC-SLP

MEDICARE: NICOLE GAIL WEDESKY M.S. CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist123321TX

General Provider Information

NPI Number : 1811707631
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE GAIL WEDESKY M.S. CCC-SLP
Provider Business Mailing Address
First Line : 214 NORTHVIEW DR
Second Line :
City : TRINIDAD
State : TX
Zip : 75163-5076
Country : US
Telephone Number : 972-804-3293
Fax Number :
Provider Business Practice Location Address
First Line : 1820 PEARL ST BLDG C
Second Line :
City : CARROLLTON
State : TX
Zip : 75006-6120
Country : US
Telephone Number : 972-968-6100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2025
Last Update Date : 04/07/2026

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Directions to “ NICOLE GAIL WEDESKY M.S. CCC-SLP” Practice Location

Language Start Address Practice Location
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