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DEBORA SUE NICHOLS LPC

>> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1205881372

Individual Registrant:
 DEBORA SUE NICHOLS LPC
Gender: F
Not Sole Proprietor

Location and contact information for practice:
26670 5TH STREET FIRST BAPTIST CHURCH ARDMORE, AL 35739 US
Tel: 256-585-0222  Fax: 256-423-7177

Contact information for business:
29319 LAKEVIEW DRIVE  ARDMORE, AL 35739 US
Tel: 256-585-0222  Fax: 256-423-7177

Registration Information:
NPI: 1205881372
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101Y00000XBehavioral Health & Social Service Providers
Counselor
AL1551

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
BCBS51524370AL01




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