Individual
TIMOTHY ROBERT NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYCHOLOGIST MS
Contact information
Practice address
97 GREAT TEAYS BLVD STE 6, SCOTT DEPOT, WV 25560-9816
(304) 757-6999
(304) 757-6999
Mailing address
103 BROOKSIDE DR, SCOTT DEPOT, WV 25560-9736
(304) 790-2432
(304) 302-0527
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1356
WV
Other
Enumeration date
06/05/2018
Last updated
09/09/2025
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