Provider Demographics
NPI:1710361043
Name:NOLAN, ANALICIA (MA, CF-SLP)
Entity Type:Individual
Prefix:
First Name:ANALICIA
Middle Name:
Last Name:NOLAN
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:ANALICIA
Other - Middle Name:
Other - Last Name:DAVILA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:865 HATCHELL LN
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-3019
Mailing Address - Country:US
Mailing Address - Phone:225-238-1741
Mailing Address - Fax:
Practice Address - Street 1:865 HATCHELL LN
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-3019
Practice Address - Country:US
Practice Address - Phone:225-238-1741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7422235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist