Individual
DR. KATHIE SUE NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3707 SW 6TH AVE, TOPEKA, KS 66606-2084
(785) 270-4630
(785) 270-4628
Mailing address
3707 SW 6TH AVE, TOPEKA, KS 66606-2084
(785) 270-4630
(785) 270-4628
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1143
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100419560A
—
KS
05
—
100419560C
—
KS
01
—
110661022
MEDICARE PTAN
KS
Enumeration date
02/17/2006
Last updated
10/12/2015
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