Individual
NICHOLE BARBARA VINCENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1223 ROYAL HAVEN DR, EAGLE PASS, TX 78852-3824
(954) 683-2958
Mailing address
1223 ROYAL HAVEN DR, EAGLE PASS, TX 78852-3824
(954) 683-2958
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
38237
TX
103TC0700X
Clinical Psychologist
PY11283
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6811
APIT
—
Enumeration date
08/12/2020
Last updated
01/27/2023
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