Individual
DEBRA JEAN NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
11 CIRCLE AVE, LYNN, MA 01905-3050
(781) 836-4054
Mailing address
11 CIRCLE AVE, LYNN, MA 01905-3050
(781) 836-4054
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1513AD
MA
Other
Enumeration date
04/02/2019
Last updated
06/11/2019
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