Individual
TRACY T. NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
U
Credential
MA, LPT, LSPE
Contact information
Practice address
2011 GALLATIN ST SW, HUNTSVILLE, AL 35801-4510
(938) 902-0494
Mailing address
623 CUMBERLAND ST E, COWAN, TN 37318-3265
(256) 505-1735
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
11784
TN
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
1185
AL
Other
Enumeration date
10/21/2024
Last updated
10/21/2024
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