Individual
MRS. STEPHANIE NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
104 BUILDERS PKWY, CORNELIA, GA 30531-5396
(678) 616-3099
Mailing address
PO BOX 1741, CLARKESVILLE, GA 30523-0030
(910) 316-0415
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP011598
GA
Other
Enumeration date
07/01/2020
Last updated
02/21/2022
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