Organization
WYATT L. NICHOLS, PH.D., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WYATT LEE NICHOLS PHD (OWNER)
(901) 388-1893
Entity
Organization
Contact information
Practice address
8142 COUNTRY VILLAGE DR STE 102, CORDOVA, TN 38016-2029
(901) 388-1893
(901) 388-1995
Mailing address
8142 COUNTRY VILLAGE DR STE 102, CORDOVA, TN 38016-2029
(901) 388-1893
(901) 388-1995
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P866
TN
103TF0200X
Forensic Psychologist
P866
TN
Other
Enumeration date
11/30/2015
Last updated
08/08/2018
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