Individual
JULIE ANN NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
30 CO RD 3398, VERNON, AZ 85940
(928) 251-2785
Mailing address
PO BOX 322, CONCHO, AZ 85924-0322
(928) 386-9237
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-1138
AZ
Other
Enumeration date
09/29/2023
Last updated
09/29/2023
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