Individual
MRS. TICA NICOLE NICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPD, CLC, CCHW
Contact information
Practice address
650 EAST AVE STE 106, ERIE, PA 16503-1535
(814) 449-6200
Mailing address
650 EAST AVE STE 106, ERIE, PA 16503-1535
(814) 449-6200
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
21072
PA
174N00000X
Lactation Consultant (Non-RN)
—
PA
374J00000X
Doula
Primary
21072
PA
Other
Enumeration date
12/06/2024
Last updated
12/06/2024
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