Individual
MS. MARLENE POPEO NICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15 JEAN DR, EAST LYME, CT 06333-1541
(860) 739-5870
Mailing address
15 JEAN DR, EAST LYME, CT 06333-1541
(860) 739-5870
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
000658
CT
Other
Enumeration date
05/10/2010
Last updated
05/10/2010
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