Individual
ANNE E. NICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.I.S.W.
Contact information
Practice address
23030 STATE ROUTE 73, WEST PORTSMOUTH, OH 45663-8861
(740) 858-1063
(740) 858-9140
Mailing address
941 MARKET ST, PIKETON, OH 45661-9757
(740) 289-2371
(740) 289-4291
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I0005226
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0188623
—
OH
Enumeration date
04/11/2006
Last updated
04/23/2019
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