Individual
MCKAYLA NICKLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
1698 HIGHWAY 160 W STE 240, FORT MILL, SC 29708-8035
(704) 654-8599
Mailing address
23144 CLARABELLE DR, CHARLOTTE, NC 28273-4392
(440) 503-1791
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
242.006805
IL
235Z00000X
Speech-Language Pathologist
Primary
8354
SC
Other
Enumeration date
01/05/2023
Last updated
06/27/2023
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