Individual
DAVIECE NICKEE CLEMENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HAIR LOSS SPECIALIST
Contact information
Practice address
0 E 4TH ST STE 14B, RICHMOND, VA 23224-4202
(804) 608-9453
Mailing address
0 E 4TH ST STE 14B, RICHMOND, VA 23224-4202
(804) 608-9453
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
1204020181
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S4080405-5
VA STATE CORPORATION COMMISSION
VA
Enumeration date
04/15/2019
Last updated
04/15/2019
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