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1568069524
PHILIP RAY NICHOLAS
JACKSON, TN
NPI
1568069524
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: TN 5027)
Enumeration Date
2020-10-02
Last Update Date
2020-10-02
Business Address
PHILIP RAY NICHOLAS LPC-MHSP
19 WOOD DUCK CV
JACKSON, TN 38305-6632
Phone number: 731-571-7500
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Mailing Address
PHILIP RAY NICHOLAS LPC-MHSP
19 WOOD DUCK CV
JACKSON, TN 38305-6632
Phone number: 731-571-7500
Copy
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