Individual
NICKIESHA NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7000 AUSTIN ST STE 200, FOREST HILLS, NY 11375-4739
(718) 762-7633
Mailing address
21904 112TH AVE, QUEENS VILLAGE, NY 11429-2538
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/31/2024
Last updated
07/31/2024
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