Individual
MRS. AMY SUSAN NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
1100 W 42ND ST STE 228, INDIANAPOLIS, IN 46208-3300
(317) 414-7632
Mailing address
1100 W 42ND ST STE 228, INDIANAPOLIS, IN 46208-3300
(317) 414-7632
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
04/04/2018
Last updated
04/04/2018
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