Individual
LAPRESE MICHELLE ROTHWELL-NIKOI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1018 ELSINORE PL, CHESTER, PA 19013-6315
(610) 874-7849
(484) 461-3537
Mailing address
116 E PROVIDENCE RD, LANSDOWNE, PA 19050-2935
(484) 802-5333
(484) 462-3329
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
143620
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
143620
COMMUNITY RESIDENTIAL REHABILITATION SVC LICENSE
PA
Enumeration date
07/05/2018
Last updated
07/05/2018
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