Individual
NICOY ANIKA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1092 WILLMOHR ST APT G4, BROOKLYN, NY 11212-2621
(646) 472-6102
Mailing address
1092 WILLMOHR ST APT G4, BROOKLYN, NY 11212-2621
(646) 472-6102
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
1333281
NY
Other
Enumeration date
07/26/2019
Last updated
07/26/2019
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