Individual
NAOMI NICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 W BROADWAY ST STE 214, OVIEDO, FL 32765-9262
(407) 792-5693
Mailing address
31 E PRINCETON ST APT B, ORLANDO, FL 32804-5049
(407) 902-7814
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
05/04/2020
Last updated
12/01/2020
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