Individual
DONALD GENE NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
628 WAVERLY AVE, NEPTUNE, NJ 07753-3196
(732) 233-8363
Mailing address
628 WAVERLY AVE, NEPTUNE, NJ 07753-3196
(732) 233-8363
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL04689700
NJ
Other
Enumeration date
04/26/2022
Last updated
04/26/2022
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