Individual
MARCY NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
104 4TH AVE SW RM 238, ALBANY, OR 97321-2804
(541) 967-3819
Mailing address
PO BOX 100, ALBANY, OR 97321-0031
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
00-11-31
OR
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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