Individual
MRS. JESSICA LYNN NICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
71 ENT RD, HANSCOM AFB, MA 01731-2605
(781) 325-1605
Mailing address
71 ENT RD, HANSCOM AFB, MA 01731-2605
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
1100634
OH
104100000X
Social Worker
Primary
218829
MA
Other
Enumeration date
08/20/2013
Last updated
08/20/2013
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