Individual
JESSICA NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 WHITNEY AVE STE 135, GRETNA, LA 70056-2577
(504) 362-0504
Mailing address
2716 GALLO DR, CHALMETTE, LA 70043-3714
(504) 317-8897
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/16/2019
Last updated
04/24/2020
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