Search › Missouri › 133V00000X
Theresa Nickolaus, RD, LD, IBCLC
NPI 1922774751 · on the registry since 2021 · sole proprietor
Practice
- Address
- 1011 Scenic Oaks Ct
Imperial, MO 63052 - Phone
- (314) 363-6186
Registry record
- Primary taxonomy
- 133V00000X
133V00000X
- Also registered as
- 174N00000X
- Licence states on file
- MO
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-08-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri