Organization
NICHOLSON PSYCHOPHYSIOLOGICAL REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELAINE RUTHE NICHOLSON PHD (OWNER)
(520) 722-2892
Entity
Organization
Contact information
Practice address
5956 E PIMA ST, SUITE 130, TUCSON, AZ 85712
(520) 722-2892
(520) 722-2873
Mailing address
PO BOX 30755, TUCSON, AZ 85751-0755
(520) 722-2892
(520) 722-2873
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0857
AZ
Other
Enumeration date
03/08/2007
Last updated
03/24/2008
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