Individual
ISHAH NICOLL ROADS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3024 NE 63RD AVE, PORTLAND, OR 97213-4510
(541) 270-6466
Mailing address
PO BOX 5462, SCOTTSDALE, AZ 85261-5462
(541) 270-6466
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C4672
OR
101YP2500X
Professional Counselor
LPC21233
AZ
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
04/18/2012
Last updated
08/23/2022
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