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Desirae Layne Nicks, CG60864058
Mental Health Counselor in Tacoma, Washington
NPI 1639641590

Desirae Layne Nicks is a Mental Health Counselor based in Tacoma, WA and is specialized in Mental Health. Desirae Layne Nicks practices in Tacoma, WA and has the professional credentials of CG60864058. The NPI Number for Desirae Layne Nicks is 1639641590 and holds a License No. CG60864058 (Washington).

The current practice location address for Desirae Layne Nicks is 3901 S Fife St Ste 301, Tacoma, WA and can be reached out via phone at 253-625-4422 and via fax at 253-584-1496.

Location: 3901 S Fife St Ste 301, Tacoma, WA, 98409-7309
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Provider Profile Details
NPI Number
1639641590
Provider Name
Desirae Layne Nicks
Credential
CG60864058
Provider Entity Type
Individual
Gender
Female
Address
3901 S Fife St Ste 301, Tacoma, WA, 98409-7309
Phone Number
253-625-4422
Fax Number
253-584-1496
Provider Enumeration Date
12/17/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
CG60864058 05 WA
institution
Provider Business Practice Location Address Details
Address
3901 S Fife St Ste 301
City
State
Zip
98409-7309
Phone Number
253-625-4422
Fax Number
253-584-1496
person
Provider Business Mailing Address Details
Address
3901 S Fife St Ste 301
City
State
Zip
98409-7309
Phone Number
253-625-4422
Fax Number
253-584-1496
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
CG60864058 (Washington)
Definition
Definition to come...
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