Individual
MS. JULIA MARY NICKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC, LMHC
Contact information
Practice address
1736 E SUNSHINE ST, STE 308, SPRINGFIELD, MO 65804-1343
(417) 812-4866
Mailing address
PO BOX 11224, SPRINGFIELD, MO 65808-1224
(417) 812-4866
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH8238
FL
101YP2500X
Professional Counselor
Primary
200011708990
MO
Other
Enumeration date
12/02/2006
Last updated
04/20/2016
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