Individual
DR. TRAVIS NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
9250 W THOMAS RD, PHOENIX, AZ 85037-3382
(623) 772-4051
Mailing address
12527 W MODESTO DR, LITCHFIELD PARK, AZ 85340-5555
(610) 283-9750
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS018367
PA
Other
Enumeration date
12/01/2017
Last updated
12/01/2017
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