Gracie N Nickum
Behavior Technician in Stuart, FL. Individual provider (NPI-1).
NPI number1962364091
StatusActive
Last updated in NPPESNov 26, 2025
Details
- NPI
- 1962364091
- Entity type
- Individual (NPI-1)
- Name
- Gracie N Nickum
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 26, 2025
- Certification date
- Nov 26, 2025
- Last updated
- Nov 26, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
7108 S Kanner HwyStuart, FL 34997-7462
Phone 855-832-6727
Mailing address
8550 Arista Pl Apt 104Broomfield, CO 80021-4176
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