Individual
KATHRYN MCNICHOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1074 S FLORIDA AVE STE 103, LAKELAND, FL 33803-1102
(863) 397-3232
Mailing address
1074 S FLORIDA AVE STE 103, LAKELAND, FL 33803-1102
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
MH11140
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MH11140
LMHC
FL
Enumeration date
02/27/2019
Last updated
02/27/2019
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