Individual
CHERYL A NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
3840 HULEN ST, HTN, CLIENT ACCOUNTING, FORT WORTH, TX 76107-7277
(817) 569-4396
(817) 569-4517
Mailing address
3840 HULEN ST, HTN, CLIENT ACCOUNTING, FORT WORTH, TX 76107-7277
(817) 569-4396
(817) 569-4517
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
18991
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
193182601
—
TX
01
—
88599L
BLUECROSSBLUESHIELD PROV#
TX
Enumeration date
02/18/2008
Last updated
05/13/2010
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