Individual
CHRISTINE MARIE NICKLAUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1557 CLEVELAND AVE, MARINETTE, WI 54143-3920
(715) 732-6868
(715) 732-6867
Mailing address
1557 CLEVELAND AVE, MARINETTE, WI 54143-3920
(715) 732-6868
(715) 732-6867
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2992226
WI
101YP2500X
Professional Counselor
Primary
6937125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033659271
ORGANIZATION NPI
—
Enumeration date
12/03/2016
Last updated
10/06/2020
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