Individual
AMY MCNICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
721 N LASALLE, CHICAGO, IL 60654
(312) 655-7284
Mailing address
9007 S LEAVITT ST, CHICAGO, IL 60643-6439
(773) 612-1124
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/17/2017
Last updated
10/17/2017
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