Individual
THERESA LOUISE NICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5800 MARSHALL AVE, NEWPORT NEWS, VA 23605-2420
(757) 247-2567
Mailing address
5800 MARSHALL AVE, NEWPORT NEWS, VA 23605-2420
(757) 247-2567
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
0813000921
VA
Other
Enumeration date
04/10/2018
Last updated
04/10/2018
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