Doctor Name: | JANET NICHOLS |
NPI Number: | 1043421217 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | MH7543 |
Business Practice Address: | 12794 W Forest Hill Blvd Wellington, FL - 334144710 |
Business Phone Number: | 5614522939 |
Business Fax Number: | |
Mailing Address: | 2796 Fawn Dr, LOXAHATCHEE |
State: | FL |
Postal Code: | 334702582 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/26/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH7543 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |