Provider Demographics
NPI:1306404785
Name:NICHOLSON, LAURA BETH (MA, SLP, CCC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:BETH
Last Name:NICHOLSON
Suffix:
Gender:F
Credentials:MA, SLP, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8249 GUNTHER CIR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-4544
Mailing Address - Country:US
Mailing Address - Phone:913-485-0341
Mailing Address - Fax:
Practice Address - Street 1:8249 GUNTHER CIR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-4544
Practice Address - Country:US
Practice Address - Phone:913-485-0341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-31
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-2419235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist