Individual
CHERYL LYNN NICCUM
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3851 ROGER BROOKE DRIVE, BROOKE ARMY MEDICAL CENTER, FORT SAN HOUSTON, TX 78234
(210) 916-5371
(210) 916-1602
Mailing address
2703 REDRIVER CREEK DR, SAN ANTONIO, TX 78259-3541
(210) 916-5371
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R039435-1
NY
Other
Enumeration date
03/10/2006
Last updated
07/08/2007
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