Individual
NIKKI HERBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2403 E HENRY AVE, TAMPA, FL 33610-4434
(813) 988-7633
(813) 914-0403
Mailing address
36100 LAKE CHASE BLVD UNIT 201, ZEPHYRHILLS, FL 33541-0936
(813) 368-5067
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001451200
—
FL
Enumeration date
04/06/2011
Last updated
05/23/2013
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