Individual
LISA NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 NE TUDOR RD, LEES SUMMIT, MO 64086-5702
(816) 986-1000
Mailing address
301 NE TUDOR RD, LEES SUMMIT, MO 64086-5702
(816) 986-1000
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
MO
Other
Enumeration date
03/11/2011
Last updated
03/11/2011
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