Individual
BRUCE MICHAEL NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., LICSW
Contact information
Practice address
1405 LILAC DR N, STE 150, GOLDEN VALLEY, MN 55422-4535
(763) 544-8194
(763) 544-4413
Mailing address
1405 LILAC DR N, STE 150, GOLDEN VALLEY, MN 55422-4535
(763) 544-8194
(763) 544-4413
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
13201
MN
Other
Enumeration date
01/03/2007
Last updated
07/08/2007
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