MS. Lacey Lee Nickerson, MS, CCP
NPI #1083738363 in Encino, California
Provider Information
- NPI Number
- 1083738363
- Entity Type
- Individual
- Name
- MS. Lacey Lee Nickerson, MS, CCP
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist/Technologist, Other
- Credential
- MS, CCP
- Enumeration Date
- Mar 19, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 16970 STRAWBERRY DR
- City
- Encino
- State
- California
- ZIP Code
- 91436-3857
- Phone
- (310) 210-0974
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist, Other |
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