Individual
THERESA MARIE NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
117 DOBBIN ST STE 204A, BROOKLYN, NY 11222-2803
(347) 255-1747
Mailing address
146 NASSAU AVE APT 2R, BROOKLYN, NY 11222-7586
(831) 247-1317
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/15/2022
Last updated
12/15/2022
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