Individual
BRIANA RENEE NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RADC-P
Contact information
Practice address
1085 MAPLE ST, FARMINGTON, MO 63640-1955
(573) 756-5353
Mailing address
2034 JACOB LN, FARMINGTON, MO 63640-7667
(573) 366-0512
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17825
MO
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17825
RADC-P
MO
Enumeration date
06/22/2021
Last updated
02/12/2025
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