Provider Demographics
NPI:1811753056
Name:NICHOLS, JULIE A (LMT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3340 ERIE AVE # 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-1624
Mailing Address - Country:US
Mailing Address - Phone:513-323-3013
Mailing Address - Fax:
Practice Address - Street 1:3340 ERIE AVE # 2
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-1624
Practice Address - Country:US
Practice Address - Phone:513-323-3013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.011600225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist