Individual
ELLEN AUDRA NICOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1208 EASTCHESTER DR, SUITE 200, HIGH POINT, NC 27265-3170
(336) 802-2536
(336) 802-2534
Mailing address
100 KIMEL FOREST DR., WINSTON SALEM, NC 27103-6074
(336) 716-1331
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1988
NC
Other
Enumeration date
07/07/2006
Last updated
10/25/2024
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