Individual
MRS. CARYLON NICKELBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4311 GABRIEL CIR, SHREVEPORT, LA 71109-6602
(318) 834-3086
Mailing address
4311 GABRIEL CIR, SHREVEPORT, LA 71109-6602
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
—
LA
235Z00000X
Speech-Language Pathologist
276
LA
Other
Enumeration date
09/23/2016
Last updated
09/23/2016
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