Individual
MS. CAROL STEVENS NICHOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1640 MADRONA AVE S, SALEM, OR 97302-4061
(503) 990-1220
Mailing address
1640 MADRONA AVE S, SALEM, OR 97302-4061
(503) 990-1220
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
225700000X
Massage Therapist
5133
OR
Other
Enumeration date
06/29/2006
Last updated
10/14/2009
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