Individual
PATRICIA M NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
502 S 4TH ST, LARAMIE, WY 82070-3704
(307) 755-1000
Mailing address
502 S 4TH ST, LARAMIE, WY 82070-3704
(307) 755-1000
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1419
WY
1041C0700X
Clinical Social Worker
838
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407205636
—
WY
Enumeration date
06/08/2016
Last updated
05/09/2022
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