Individual
MS. BRENDA LARUE NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MFT INTERN
Contact information
Practice address
4025 W 226TH ST, TORRANCE, CA 90505-2340
(310) 373-4556
(310) 373-4096
Mailing address
13107 S SAINT ANDREWS PL, GARDENA, CA 90249-1831
(310) 400-3009
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
58785
CA
Other
Enumeration date
02/23/2007
Last updated
02/22/2011
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