Individual
MRS. LACEY A NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1210 DRY HOLLOW RD STE 4 1/2, THE DALLES, OR 97058-3167
(541) 240-8938
Mailing address
1210 DRY HOLLOW RD STE 4 1/2, THE DALLES, OR 97058-3167
(541) 240-8938
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L11457
OR
Other
Enumeration date
08/27/2013
Last updated
11/02/2023
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