Individual
REBECCA NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 CENTER ST, AUBURN, ME 04210-6404
(207) 782-2726
(207) 333-3501
Mailing address
655 MAIN ST, LEWISTON, ME 04240-5938
(207) 782-2726
(207) 333-3501
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT2546
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT2546
MAINE
ME
Enumeration date
10/14/2011
Last updated
10/14/2011
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