Individual
ERICA STACY NIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
633 THORNBIRD CIR, BOILING SPRINGS, SC 29316-5364
(864) 516-2684
Mailing address
633 THORNBIRD CIR, BOILING SPRINGS, SC 29316-5364
(864) 516-2684
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-34653
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-19-34653
BACB
SC
Enumeration date
08/02/2016
Last updated
06/11/2019
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