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1174014252
BRUCE CHARLES NICKLES
SAN JOSE, CA
NPI
1174014252
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA 39460)
Enumeration Date
2018-05-23
Last Update Date
2018-05-23
Business Address
Mr. BRUCE CHARLES NICKLES MFT
151 W MISSION ST
SAN JOSE, CA 95110-1713
Phone number: 408-535-4255
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Mailing Address
Mr. BRUCE CHARLES NICKLES MFT
PO BOX 110681
CAMPBELL, CA 95011-0681
Phone number: 408-593-1688
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