Individual
REBECCA A NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
210 SIMMONS ST, MARYVILLE, TN 37801
(865) 970-9800
(865) 983-4518
Mailing address
210 SIMMONS ST, MARYVILLE, TN 37801-4750
(865) 970-9800
(865) 983-4518
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4224
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3927817
—
TN
Enumeration date
03/09/2006
Last updated
01/22/2019
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