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Individual
MS. MOLLY BETH NICKERSON
Active
Individual
MS. MOLLY BETH NICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, ACSW
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053560573
—
CA
Enumeration date
09/09/2008
Last updated
01/19/2017
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