Individual
MRS. DONNA KAY NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
1085 MAPLE ST, FARMINGTON, MO 63640-1955
(314) 315-7645
Mailing address
1430 OLIVE ST STE 400, SAINT LOUIS, MO 63103-2303
(314) 206-3200
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CS2309
MO
101YP2500X
Professional Counselor
CS2309
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
498723212
—
MO
Enumeration date
06/29/2007
Last updated
01/11/2023
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