Individual
LISA H NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, RN, BC
Contact information
Practice address
216 SAILORS DR STE 131, ELLIJAY, GA 30540-3747
(706) 636-1386
(706) 636-1396
Mailing address
216 SAILORS DR STE 131, ELLIJAY, GA 30540-3747
(706) 636-1386
(706) 636-1396
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW000618
GA
Other
Enumeration date
03/18/2008
Last updated
03/18/2008
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