Individual
NICKOLAS SLOAN HUSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2371 W MAIN ST SPC 57, BARSTOW, CA 92311-3614
(909) 963-6044
Mailing address
2371 W MAIN ST SPC 57, BARSTOW, CA 92311-3614
(909) 963-6044
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
F5775801
CA
Other
Enumeration date
02/24/2020
Last updated
02/24/2020
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