Provider Demographics
NPI:1376659284
Name:NELSON, CHARLES THOMAS (MS, CCC-A)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:THOMAS
Last Name:NELSON
Suffix:
Gender:M
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:521 6TH ST
Mailing Address - Street 2:APT. A
Mailing Address - City:OAKMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15139-1652
Mailing Address - Country:US
Mailing Address - Phone:412-365-4545
Mailing Address - Fax:412-365-5126
Practice Address - Street 1:7180 HIGHLAND DRIVE
Practice Address - Street 2:VA MEDICAL CENTER 132A-H AUDIOLOGY
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-1297
Practice Address - Country:US
Practice Address - Phone:412-365-4545
Practice Address - Fax:412-365-5126
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000128L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist