Individual
MRS. DONNA SHEMANNE NICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
621 SW JOHNSON AVE, BURLESON, TX 76028-5833
(817) 374-0155
Mailing address
PO BOX 24223, FORT WORTH, TX 76124-1223
(817) 374-0155
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
36829
TX
Other
Enumeration date
05/22/2014
Last updated
05/22/2014
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