| NPI | 1740666452 |
|---|---|
| Former Name | CIERRA NICKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 71068) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 71068) |
| 251B00000X Case Management | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: TX 71068) | |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2024-06-12 |