Provider Demographics
NPI:1437384989
Name:HENRIKSON SOMMERS, NANCY (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:HENRIKSON SOMMERS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5025 220TH ST E
Mailing Address - Street 2:
Mailing Address - City:FARIBAULT
Mailing Address - State:MN
Mailing Address - Zip Code:55021-8194
Mailing Address - Country:US
Mailing Address - Phone:507-334-8751
Mailing Address - Fax:
Practice Address - Street 1:5025 220TH ST E
Practice Address - Street 2:
Practice Address - City:FARIBAULT
Practice Address - State:MN
Practice Address - Zip Code:55021-8194
Practice Address - Country:US
Practice Address - Phone:507-334-8751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8447235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist