Individual
DANIELLE NICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
635 N 12TH ST STE 101, LEMOYNE, PA 17043-1225
(717) 585-0627
Mailing address
129 E PORTLAND ST, MECHANICSBURG, PA 17055-3333
(215) 208-0917
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC015412
PA
106H00000X
Marriage & Family Therapist
—
PA
Other
Enumeration date
02/16/2023
Last updated
03/12/2023
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