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Individual

TISHA NICHOLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3710 S LENOIR ST, COLUMBIA, MO 65201-5463
(573) 876-5800
Mailing address
5203 LOOKOUT PEAK DR, COLUMBIA, MO 65202-3563
(573) 864-7521

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2011040057
MO

Other

Enumeration date
02/07/2023
Last updated
02/07/2023
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