Most Relevant Information
Provider Data
| NPI Number: | 1003071077 |
| Provider Name: | MICHELLE LYNN NICHOLS |
| Entity Type: | Individual |
| Taxonomy Code: | 222Q00000X |
| Specialty: | Developmental Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/18/2008 |
| Last Updated: | 07/18/2008 |
Provider Practice Location
9081 WALLONIA RD
PRINCETON
KY
424459012
Practice Location Phone/Fax
| Phone: | 2705229212 |
| Fax: | 8663242993 |
Provider Mailing Location
9081 WALLONIA RD
PRINCETON
KY
424459012
Provider Mailing Phone/Fax
| Phone: | 2705229212 |
| Fax: | 8663242993 |