Individual
TED WAYNE NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7823 DAIRY RIDGE RD, MEBANE, NC 27302-9281
(919) 563-1927
Mailing address
7823 DAIRY RIDGE RD, MEBANE, NC 27302-9281
(919) 563-1927
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0717000648
VA
Other
Enumeration date
08/23/2011
Last updated
08/23/2011
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