Individual
KRYSTAL DAWN NICKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
500 MEMORIAL AVE, SUITE M304, CUMBERLAND, MD 21502-3732
(240) 580-1919
Mailing address
4 OAKLAWN AVE, LAVALE, MD 21502-7307
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LGP4638
MD
Other
Enumeration date
09/05/2012
Last updated
10/18/2012
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