Individual
SUZANNE LEA NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SSP
Contact information
Practice address
111 SCHOOL ST, ROMNEY, WV 26757-1522
(304) 822-3528
Mailing address
111 SCHOOL ST., ROMNEY, WV 26757
(304) 822-3528
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1204
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810002064
—
WV
Enumeration date
02/13/2008
Last updated
02/13/2008
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