Individual
MS. ALICIA MICHELLE NICHOLS-MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
269 WESTLAKE RD STE 201, FAYETTEVILLE, NC 28314-4868
(252) 341-4192
Mailing address
945 N CENTRAL AVE, WOODMERE, NY 11598-1604
(516) 703-6400
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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