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Individual

MALCOLM HENRY NICHOLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4441 DIPLOMACY DR, ANCHORAGE, AK 99508-5910
(907) 729-8880
Mailing address
7033 E TUDOR RD, ANCHORAGE, AK 99507-1262

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
07/08/2019
Last updated
07/08/2019
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