Individual
JESSICA DIANE NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
6439 GARNERS FERRY ROAD, COLUMBIA, SC 29208-4123
(803) 776-4000
Mailing address
1140 KARLANEY AVE, CAYCE, SC 29033-3219
(201) 206-9839
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
Primary
1468
SC
Other
Enumeration date
06/17/2011
Last updated
07/21/2022
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