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Individual
LIBERTY LOUISE NICHOLAS
Active
Individual
LIBERTY LOUISE NICHOLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
55861
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
99-4129751
PRIVATE THERAPY PRACTICE
TX
Enumeration date
01/29/2024
Last updated
08/16/2024
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