Individual
MOREEN N NICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
574 MAIN ST, SUITE 203, EAST AURORA, NY 14052-1751
(716) 608-3110
Mailing address
574 MAIN ST, SUITE 203, EAST AURORA, NY 14052-1751
(716) 608-3110
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86001885
NY
Other
Enumeration date
02/11/2013
Last updated
02/11/2013
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