Provider Demographics
NPI:1831585769
Name:VANCO, NANCY ANNA (MA/CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:NANCY
Middle Name:ANNA
Last Name:VANCO
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 1:379 BOSTIC RD
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-8519
Mailing Address - Country:US
Mailing Address - Phone:740-645-7600
Mailing Address - Fax:
Practice Address - Street 1:439 LAKE DR.
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:OH
Practice Address - Zip Code:45674
Practice Address - Country:US
Practice Address - Phone:740-245-5333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-11198235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist