Organization
SHANA M. NICHOLAS, PSY.D. PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANA M. NICHOLAS PSY.D. (CLINICAL PSYCHOLOGIST)
(847) 732-1704
Entity
Organization
Contact information
Practice address
636 CHURCH ST STE 515, EVANSTON, IL 60201-4581
(847) 732-1704
Mailing address
636 CHURCH ST STE 515, EVANSTON, IL 60201-4581
(847) 732-1704
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Enumeration date
09/12/2007
Last updated
09/12/2007
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