Individual
SAMANTHA NICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2471 LOUISIANA AVE, LUTCHER, LA 70071-5413
(225) 258-6103
Mailing address
2471 LOUISIANA AVE, LUTCHER, LA 70071-5413
(225) 258-6103
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
15835
LA
Other
Enumeration date
02/16/2021
Last updated
02/16/2021
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