Organization
WYATT L. NICHOLS, PH.D., PC
Active
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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