Doctor Name: | MRS. PATRICIAN NICHOLSON |
NPI Number: | 1346426418 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC, NCC |
License Number: | 4721 |
Business Practice Address: | 402 Ocean Pointe Ct North Myrtle Beach, SC - 295822983 |
Business Phone Number: | 9105206367 |
Business Fax Number: | |
Mailing Address: | 402 Ocean Pointe Ct, NORTH MYRTLE BEACH |
State: | SC |
Postal Code: | 295822983 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/18/2008 |
NPI Last Update Date: | 01/18/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 4721 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |