Individual
MRS. CYNTHIA NICHOLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2426 VALENCE ST, NEW ORLEANS, LA 70115-5962
(504) 316-1601
(504) 316-1601
Mailing address
2424 VALENCE ST, NEW ORLEANS, LA 70115-5962
(504) 316-1601
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
455566971
LA
Other
Enumeration date
07/11/2017
Last updated
07/11/2017
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