Provider Demographics
NPI:1639895162
Name:REDMOND, NICOLA KAIL (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NICOLA
Middle Name:KAIL
Last Name:REDMOND
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 PHEASANTLAKE DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-7139
Mailing Address - Country:US
Mailing Address - Phone:513-815-1645
Mailing Address - Fax:
Practice Address - Street 1:2040 US HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:OH
Practice Address - Zip Code:45103-8694
Practice Address - Country:US
Practice Address - Phone:513-732-4969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH14441828235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist