Individual
DR. ANASTACIA A. NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
12 EXECUTIVE PARK DR NE, ATLANTA, GA 30329-2206
(404) 712-5667
Mailing address
1441 CLIFTON RD NE STE 170, ATLANTA, GA 30322-1004
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY004308
GA
103TC0700X
Clinical Psychologist
Primary
PSY004308
GA
Other
Enumeration date
07/03/2019
Last updated
01/20/2026
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