Provider Demographics
NPI:1619259827
Name:NYKAMP, LAUREN ESTELLE (MA CFY-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:ESTELLE
Last Name:NYKAMP
Suffix:
Gender:F
Credentials:MA CFY-SLP
Other - Prefix:MRS
Other - First Name:LAUREN
Other - Middle Name:ESTELLE
Other - Last Name:ROODVOETS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CFY-SLP
Mailing Address - Street 1:2505 ARDMORE ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-4924
Mailing Address - Country:US
Mailing Address - Phone:616-559-1054
Mailing Address - Fax:616-559-1056
Practice Address - Street 1:2505 ARDMORE ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-4924
Practice Address - Country:US
Practice Address - Phone:616-559-1054
Practice Address - Fax:616-559-1056
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist