Individual
MISTI NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3000 JOE DIMAGGIO BLVD, SUITE 66, ROUND ROCK, TX 78665-3922
(512) 246-7225
Mailing address
3000 JOE DIMAGGIO BLVD, SUITE 66, ROUND ROCK, TX 78665-3922
(512) 246-7225
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
36270
TX
Other
Enumeration date
07/11/2008
Last updated
05/09/2013
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