Provider Demographics
NPI:1144597212
Name:AESCH, NANCY BADGER (CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:BADGER
Last Name:AESCH
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 PADDY LN
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:NY
Mailing Address - Zip Code:14519-9534
Mailing Address - Country:US
Mailing Address - Phone:315-524-6701
Mailing Address - Fax:
Practice Address - Street 1:10456 SALTER RD
Practice Address - Street 2:
Practice Address - City:NORTH ROSE
Practice Address - State:NY
Practice Address - Zip Code:14516-9708
Practice Address - Country:US
Practice Address - Phone:315-587-4005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007654-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist