Individual
NICKIE MARIE GAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
204 N MAIN ST, ENTERPRISE, AL 36330-2539
(334) 350-0711
Mailing address
PO BOX 311785, ENTERPRISE, AL 36331-1785
(334) 350-0711
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/28/2018
Last updated
09/28/2018
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