Individual
DR. NINA NICOLE JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
766 HL ROSS DR, MONTICELLO, AR 71655
(870) 367-6246
(855) 926-7383
Mailing address
PO BOX 509, DERMOTT, AR 71638
(870) 538-5414
(870) 538-5412
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
15-06P
AR
103TC0700X
Clinical Psychologist
PSY003323
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003100346A
—
GA
Enumeration date
05/12/2010
Last updated
07/21/2022
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