Provider Demographics
NPI:1881316453
Name:ANDERSON, NICHOLE CHRISTIANSON
Entity type:Individual
Prefix:
First Name:NICHOLE
Middle Name:CHRISTIANSON
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9607 TOP GALLANT CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-4916
Mailing Address - Country:US
Mailing Address - Phone:225-603-5917
Mailing Address - Fax:
Practice Address - Street 1:10300 JONES RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4208
Practice Address - Country:US
Practice Address - Phone:281-897-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist