Individual
MRS. DEBORAH ANN NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
509 MDG, 331 SIJAN AVENUE, WHITEMAN AFB, MO 65305
(660) 687-4412
Mailing address
509 MDG, 331 SIJAN AVENUE, WHITEMAN AFB, MO 65305
(660) 687-4412
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
004672
MO
1041C0700X
Clinical Social Worker
SW004672
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23810
BCBS
MO
05
—
497884338
—
MO
Enumeration date
06/18/2006
Last updated
11/30/2021
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