Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath |
NPI | 1285017053 |
---|---|
Provider Name | Nikkita Richardson |
First Address | Pflugerville, TX 78660-5906 |
Second Address | Pflugerville, TX 78660-5906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2015 |
Last Update Date | 29/06/2015 |