Individual provider · Type 1 NPI
Logan Rene Nickerson, CADC
Addiction (Substance Use Disorder) Counselor · Dover, DE
NPI number
1487465704
Active
Practice location
103 Wolf Creek Blvd Ste 2&3
Dover, DE 19901-4967
Mailing address
114 Logan Dr
Dover, DE 19901-1583
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 2346 (DE) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
Another provider at this address
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About NPI 1487465704
Logan Rene Nickerson, CADC's National Provider Identifier is 1487465704, issued on Jan 16, 2025. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Dover, DE. The record was last updated on Jan 16, 2025.