Provider Information for 1710337142
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Mrs. JUDY NICHOLS LCSW
Sex: Female
NPI: 1710337142
Last Updated: 2016-06-16
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1710337142 | ||||||||
| Enumeration Date | 2016-06-16 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2012 LONG BEACH BLVD SURF CITY, NJ 08008-5551 United States Phone: 609-276-1660 | Fax: | ||||||||
| Primary Practice Address | 2012 LONG BEACH BLVD SURF CITY, NJ 08008-5551 United States Phone: 609-276-1660 | Fax: | ||||||||
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