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Individual

MS. SHARON NICHOLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CTRS/L

Contact information

Practice address
903 WHITE CEDAR BLVD, PORTSMOUTH, NH 03801-6527
(603) 433-0823
Mailing address
903 WHITE CEDAR BLVD, PORTSMOUTH, NH 03801-6527
(603) 433-0823

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001
STATE OF NH
NH
01
10275
NATIONAL COUNCIL FOR THERAPEUTIC RECREATION CERTIFICATION
NY
Enumeration date
08/17/2007
Last updated
03/22/2012
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