Individual
KERRI LAUREN NICKLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.S.
Contact information
Practice address
825 E 075 N, LAGRANGE, IN 46761-9360
(260) 499-2400
Mailing address
825 E 075 N, LAGRANGE, IN 46761-2099
(260) 499-2400
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
10322352
IN
Other
Enumeration date
09/26/2024
Last updated
09/26/2024
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