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Individual

DR. BARBARA ANNE NICELY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
429 FRONT ST, BEREA, OH 44017-1716
(216) 926-4921
(440) 234-2072
Mailing address
3951 ROSEMOND RD, CLEVELAND HEIGHTS, OH 44121-2401
(216) 381-9541
(216) 291-8320

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5926
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2415774
OH
Enumeration date
01/21/2007
Last updated
12/28/2010
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