Nicole Ping Ticknor, LPC

NPI #1023489853 in Rockford, Illinois

Provider Information

NPI Number: 1023489853
Entity Type: Individual
Name: Nicole Ping Ticknor, LPC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Professional
Credential: LPC
Enumeration Date: Oct 20, 2015
Last Updated: Oct 20, 2015

Practice Location

Address: 433 S. PHELPS AVE.
Address 2: SUITE 2
City: Rockford
State: Illinois
ZIP Code: 61108
Phone: (815) 397-4287

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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