| NPI | 1225912041 |
|---|---|
| Former Name | LACEY NICKELS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC A21153) |
| Additional Taxonomies | 101YS0200X Counselor School (Licence: NC 1282791) |
| Enumeration Date | 2025-08-04 |
| Last Update Date | 2025-08-04 |