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Individual

CHRISTINA NICKLIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2208 L ST, BARLING, AR 72923-1639
(479) 883-1395
Mailing address
2208 L ST, BARLING, AR 72923-1639
(479) 883-1395

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP#1310
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
190325721
AR
Enumeration date
05/10/2012
Last updated
05/10/2012
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