Organization
KELLY L NICHOLSON, PSYD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY L NICHOLSON PSYD (PSYCHOLOGIST)
(843) 226-6690
Entity
Organization
Contact information
Practice address
19 SHELTER COVE LN, HILTON HEAD ISLAND, SC 29928-3520
(843) 226-6690
Mailing address
22 REDBUD WAY, BLUFFTON, SC 29910-5605
(843) 226-6690
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1340
SC
Other
Enumeration date
08/21/2015
Last updated
08/21/2015
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