Provider Demographics
NPI:1578752994
Name:PRITCHETT, NIKKI JEANNE (PHD)
Entity Type:Individual
Prefix:
First Name:NIKKI
Middle Name:JEANNE
Last Name:PRITCHETT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:NIKKI
Other - Middle Name:J
Other - Last Name:FULKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:942 LEARNING WAY
Mailing Address - Street 2:ASKEW STUDENT LIFE CENTER, SUITE 201
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32306-4175
Mailing Address - Country:US
Mailing Address - Phone:850-644-2003
Mailing Address - Fax:850-644-3150
Practice Address - Street 1:942 LEARNING WAY
Practice Address - Street 2:ASKEW STUDENT LIFE CENTER, SUITE 201
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32306-4175
Practice Address - Country:US
Practice Address - Phone:850-644-2003
Practice Address - Fax:850-644-3150
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 5900103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling