Provider Demographics
NPI:1508285354
Name:NICHOLS-JONES, NATALIE (PSYD)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:NICHOLS-JONES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17430 CAMPBELL RD
Mailing Address - Street 2:STE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5212
Mailing Address - Country:US
Mailing Address - Phone:214-305-8217
Mailing Address - Fax:
Practice Address - Street 1:17430 CAMPBELL RD
Practice Address - Street 2:STE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-5212
Practice Address - Country:US
Practice Address - Phone:214-305-8217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37348103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical