Individual
KATHARINE MACY NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
127 W STATE ST, ITHACA, NY 14850-5474
(607) 273-7494
(607) 273-7484
Mailing address
702 VALLEY RD, BROOKTONDALE, NY 14817-9704
(607) 351-7520
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336163963
—
NY
Enumeration date
09/13/2011
Last updated
01/29/2015
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