Individual
MS. STEPHANIE RENEE NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1970 ROANOKE BLVD, SALEM, VA 24153-6404
(540) 982-2463
(540) 224-1957
Mailing address
1970 ROANOKE BLVD, SALEM, VA 24153-6404
(540) 982-2463
(540) 224-1957
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCSW-13938
AZ
Other
Enumeration date
03/11/2014
Last updated
05/27/2015
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