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Individual

DR. STEPHEN DAVID NICHOLSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
1701 GATEWAY BLVD, RICHARDSON, TX 75080-3572
(214) 435-6313
(972) 644-5512
Mailing address
1701 GATEWAY BLVD, RICHARDSON, TX 75080-3572
(214) 435-6313
(972) 644-5512

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
23273
TX
103TC2200X
Clinical Child & Adolescent Psychologist
23273
TX
103TF0000X
Family Psychologist
23273
TX
103TP2701X
Group Psychotherapy Psychologist
23273
TX

Other

Enumeration date
03/17/2010
Last updated
03/17/2010
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