Individual
TISHA BRUCINE NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1525 HUGUENOT RD STE 100, MIDLOTHIAN, VA 23113-2438
(804) 924-7600
(804) 729-3525
Mailing address
10100 BRIGHTSTONE DR, MIDLOTHIAN, VA 23112-1566
(804) 519-1684
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701012581
VA
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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