Individual
DR. AMANDA NICOLE NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LMFT, ME.D.
Contact information
Practice address
269 HIGHWAY 138 SW APT 902, RIVERDALE, GA 30274-4064
(678) 549-4263
Mailing address
269 HIGHWAY 138 SW APT 902, RIVERDALE, GA 30274-4064
(678) 549-4263
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT001741
GA
Other
Enumeration date
06/09/2020
Last updated
06/09/2020
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