Individual
SKYLAR JORDAN NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
9666 OLIVE BLVD, SAINT LOUIS, MO 63132-3013
(314) 649-0570
Mailing address
6202 ARTHUR AVE, SAINT LOUIS, MO 63139-2017
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2019018317
MO
Other
Enumeration date
07/20/2019
Last updated
07/20/2019
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