National Provider Identifier

Nicole Johnson

Nicole Johnson is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Rochester, NY and a listed phone number of (585) 617-2314.

NPI 1659664571Rochester, NYSpeech-Language Pathologist

Profile Overview

NPI
1659664571
Provider Type
Individual
Primary Specialty
Speech-Language Pathologist
Enumeration Date
May 25, 2011
Last Updated
August 07, 2023

Practice Location

  • 160 Wallace Way Bldg 9
  • Rochester, NY 14624

Phone: (585) 617-2314

Mailing Address

  • PO Box 297
  • Spencerport, NY 14559-0297

Specialties

  • Speech-Language Pathologist (235Z00000X)
  • Speech-Language Pathologist (235Z00000X)
Full Record
NPI
1659664571
Entity Type
Individual
Last Name
Johnson
First Name
Nicole
Provider Other Last Name
Johnson
Provider Other First Name
Nicole
Provider Other Middle Name
P
Provider Other Last Name Type Code
2
Mailing Street Address
PO Box 297
Mailing City
Spencerport
Mailing State
NY
Mailing ZIP Code
14559-0297
Mailing Country
US
Mailing Phone
(716) 984-1296
Practice Street Address
160 Wallace Way Bldg 9
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14624
Practice Country
US
Practice Phone
(585) 617-2314
Enumeration Date
May 25, 2011
Last Updated
August 07, 2023
Sex
Female
Sole Proprietor
Yes
Certification Date
August 07, 2023
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Speech-Language Pathologist (235Z00000X), Speech-Language Pathologist (235Z00000X)