Individual
KATELYN E NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
701 DECATUR AVE N STE 109, GOLDEN VALLEY, MN 55427-4363
(763) 746-2400
(763) 746-2401
Mailing address
701 DECATUR AVE N STE 109, GOLDEN VALLEY, MN 55427-4363
(763) 746-2400
(763) 746-2401
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
24502
MN
Other
Enumeration date
06/13/2018
Last updated
06/13/2018
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