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1003431495
TRAVIS GEORGE NICHOLS
SACRAMENTO, CA
NPI
1003431495
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1370771119)
Enumeration Date
2020-06-10
Last Update Date
2020-06-10
Business Address
TRAVIS GEORGE NICHOLS
1914 22ND ST
SACRAMENTO, CA 95816-7109
Phone number: 916-455-6258
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Mailing Address
TRAVIS GEORGE NICHOLS
1914 22ND ST
SACRAMENTO, CA 95816-7109
Phone number: 916-455-6258
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