Individual
MEISHA B NICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
86 DAVIS RD, BANGOR, ME 04401-2311
(207) 992-2205
Mailing address
268 STILLWATER AVE, BANGOR, ME 04401-3945
(207) 973-6100
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
LC20031
ME
Other
Enumeration date
09/13/2017
Last updated
02/16/2024
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