Kimberly Ann Nelson, M.A., CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Williamsville, NY

NPI 1780997635 · NPPES record last updated Jul 21, 2010

Key facts

NPI
1780997635
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
019278 (NY)
Practice address
4444 Bryant Stratton Way
Williamsville, NY 14221-6013
Phone
(716) 631-5777
NPI assigned
Jul 21, 2010
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
019278NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Autistic Services, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 019278 NY Yes

Addresses

Primary practice location

4444 Bryant Stratton Way
Williamsville, NY 14221-6013

Mailing address

4444 Bryant Stratton Way
Williamsville, NY 14221-6013
Phone (716) 631-5777

Other providers in Williamsville, NY

All providers in Williamsville, NY · Speech-Language Pathologist in New York

Sources for this page

Verify at the official NPI Registry.