| NPI | 1639532369 |
|---|---|
| Other Name | TONY NICHOLS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IL 180011713) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 180011713) |
| 101YP2500X Counselor Professional (Licence: IL 180011713) | |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2019-01-26 |