Individual
NICHOLAS JOSEPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1520 S GRANT ST, LONGWOOD, FL 32750-6538
(718) 362-1411
(718) 414-1651
Mailing address
612 CORPORATE WAY STE 2M, VALLEY COTTAGE, NY 10989-2027
(718) 362-1411
(718) 414-1651
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY11985
FL
Other
Enumeration date
09/12/2023
Last updated
09/12/2023
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