Individual
DR. KELLY L NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1605 MOONSTONE LN, CASTLE ROCK, CO 80108-7809
(720) 588-6772
Mailing address
22 REDBUD WAY, BLUFFTON, SC 29910-5605
(843) 226-6690
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1340
SC
103TC0700X
Clinical Psychologist
3154
CO
Other
Enumeration date
05/10/2007
Last updated
08/21/2015
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