| NPI | 1396961603 |
|---|---|
| Former Name | SARA R NICKERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 60836) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA 28552) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2015-12-29 |