Provider Demographics
NPI:1083615314
Name:LAMPI, NICOLE (SLP)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:LAMPI
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6997 POLARIS LN N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311-3219
Mailing Address - Country:US
Mailing Address - Phone:763-420-6909
Mailing Address - Fax:
Practice Address - Street 1:9220 BASS LAKE RD
Practice Address - Street 2:SUITE 260
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55428-3000
Practice Address - Country:US
Practice Address - Phone:763-533-0363
Practice Address - Fax:763-533-0842
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7301235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist