Nickolaus, Theresa Renee

Nickolaus, Theresa Renee is an sole proprietor health care provider with primary practice located at 1011 Scenic Oaks Ct , Imperial MO 63052-3457. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Lactation Consultant, Non-RN, Dietary & Nutritional Service Providers / Dietitian, Registered. Dietary & Nutritional Service Providers / Dietitian, Registered is her primary health care specialty. Nickolaus, Theresa Renee can be contacted via phone (314) 363-6186.

Contact Information

Primary practice address
1011 Scenic Oaks Ct Imperial MO 63052-3457
Phone: (314) 363-6186
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Lactation Consultant, Non-RN 174N00000X L-124884
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 2011041352 Missouri

Profile Details

NPI number 1922774751
LBN Legal business name Nickolaus, Theresa Renee
Credentials RD, LD, IBCLC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 20th, 2021
Last updated Aug 20th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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