NPI 1316555329

Madeline Nicklas, CPSS

Practitioner Peer Specialist Gulfport, MS

Practice location

Address: 1600 Broad Ave, Gulfport, MS 39501-3603
Phone: (228) 863-1132
Mailing address: PO Box 6705, Gulfport, MS 39506-6705

Registered specialties

Peer Specialist Primary

Other Service Providers Taxonomy 175T00000X

Other Peer Specialist providers in Mississippi →

Registry record

NPI: 1316555329
Entity type: Individual
Sex (as registered): Female
NPI issued: 15 Jul 2020
Record last updated: 15 Jul 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.