Individual
LAURA JEANNE NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
31 6TH ST, MALONE, NY 12953-1246
(518) 651-2290
Mailing address
25 COUNTY ROUTE 51, WINTHROP, NY 13697-3144
(315) 328-5911
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/03/2019
Last updated
03/03/2019
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