Individual
BRET TYLER NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
149 MERCY BLVD, MOUNT ORAB, OH 45154-0296
(937) 721-3121
Mailing address
149 MERCY BLVD, MOUNT ORAB, OH 45154-0296
(937) 721-3121
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/01/2023
Last updated
11/29/2023
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