Individual
MR. JASEN RALPH NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
201 RITCHIE COUNTY SCHOOL RD, ELLENBORO, WV 26346-6704
(304) 869-3650
Mailing address
201 RITCHIE COUNTY SCHOOL RD, ELLENBORO, WV 26346-6704
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1011
WV
Other
Enumeration date
03/02/2012
Last updated
04/10/2026
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