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Individual
NICHOLE BONNIE GREGORY
Active
Individual
NICHOLE BONNIE GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.A.D.C. LICENSE ALC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
857
NE
103K00000X
Behavior Analyst
P658
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13947938
CAQH
—
Enumeration date
09/01/2009
Last updated
07/21/2022
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