Provider Demographics
NPI:1801063896
Name:NICHOLS, JOHN WESLEY (BS)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:WESLEY
Last Name:NICHOLS
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:106 S JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:KAUFMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75142-1928
Mailing Address - Country:US
Mailing Address - Phone:903-467-7073
Mailing Address - Fax:972-932-4437
Practice Address - Street 1:106 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:KAUFMAN
Practice Address - State:TX
Practice Address - Zip Code:75142-1928
Practice Address - Country:US
Practice Address - Phone:903-467-7073
Practice Address - Fax:972-932-4437
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor