| Doctor Name: | NICOLE ANDERS |
| NPI Number: | 1053771105 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | 28048 |
| Business Practice Address: | 6900 Pecos Rd N Las Vegas, NV - 890864400 |
| Business Phone Number: | 7027919000 |
| Business Fax Number: | |
| Mailing Address: | 8450 W Charleston Blvd, #2082 LAS VEGAS |
| State: | NV |
| Postal Code: | 891179010 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/02/2016 |
| NPI Last Update Date: | 03/02/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 28048 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |