Provider Demographics
NPI:1245868520
Name:GREGG, NANCY ENGER (MS, CCC-SLP, LSLS)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:ENGER
Last Name:GREGG
Suffix:
Gender:F
Credentials:MS, CCC-SLP, LSLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 MONTEVALLO RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2317
Mailing Address - Country:US
Mailing Address - Phone:205-901-5506
Mailing Address - Fax:205-728-5480
Practice Address - Street 1:2305 MONTEVALLO RD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-2317
Practice Address - Country:US
Practice Address - Phone:205-901-5506
Practice Address - Fax:205-728-5480
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-31
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL752235Z00000X
231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist