Individual
DALLAS NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1505 BLANDING ST, COLUMBIA, SC 29201-2906
(803) 929-0011
Mailing address
1505 BLANDING ST, COLUMBIA, SC 29201-2906
(803) 929-0011
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/22/2018
Last updated
03/13/2019
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