Individual
LELA NICKENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3700 MARTIN LUTHER KING JR DR SW, ATLANTA, GA 30331-3674
(404) 486-9034
Mailing address
1030 FAYETTEVILLE RD SE, ATLANTA, GA 30316-2921
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/02/2020
Last updated
07/02/2020
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