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1679124739
JODY NICHOLS
VIDALIA, LA
NPI
1679124739
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: LA CIT-5033)
Enumeration Date
2019-09-20
Last Update Date
2021-02-04
Business Address
JODY NICHOLS
806 CARTER ST
VIDALIA, LA 71373-3206
Phone number: 318-734-0034
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Mailing Address
JODY NICHOLS
806 CARTER ST
VIDALIA, LA 71373-3206
Phone number: 318-734-0034
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