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Individual

DR. WYATT LEE NICHOLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
8142 COUNTRY VILLAGE DR STE 102, CORDOVA, TN 38016-2029
(901) 388-1893
(901) 388-1995
Mailing address
8142 COUNTRY VILLAGE DR STE 102, CORDOVA, TN 38016-2029
(901) 388-1893
(901) 388-1995

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P866
TN
103TF0200X
Forensic Psychologist
P866
TN

Other

Enumeration date
07/07/2006
Last updated
08/08/2018
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