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1225623556
TARA ELIZABETH NICHOLS
DOUGLASVILLE, GA
NPI
1225623556
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: GA LPC012024)
Enumeration Date
2021-03-08
Last Update Date
2021-03-08
Business Address
TARA ELIZABETH NICHOLS MHC, LPC
6130 PRESTLEY MILL RD STE A
DOUGLASVILLE, GA 30134-2288
Phone number: 770-949-9675
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Mailing Address
TARA ELIZABETH NICHOLS MHC, LPC
3050 AUTUMN WOODS CT
DOUGLASVILLE, GA 30135-7342
Phone number: 678-634-8989
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