| Doctor Name: | NICHOLA ANDERSON |
| NPI Number: | 1205051422 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | TLSW |
| License Number: | |
| Business Practice Address: | 1609 W 3rd Ave Williamson, WV - 256613006 |
| Business Phone Number: | 3042350026 |
| Business Fax Number: | |
| Mailing Address: | Po Box 552, WHITMAN |
| State: | WV |
| Postal Code: | 256520552 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/14/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |