Individual
REBECCA ANN NICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
ELLIE MENTAL HEALTH SERVICES, 4001 PRINCE WILLIAM PARKWAY, WOODBRIDGE, VA 22192
(703) 688-8541
Mailing address
2801 S COLUMBUS ST, ARLINGTON, VA 22206-1410
(202) 617-1680
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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