MEDICARE: NATALIE NICHOLS-JONES PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	37348	TX

General Provider Information

NPI Number	:	1508285354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE NICHOLS-JONES PSY.D.

Provider Business Mailing Address
First Line	:	17430 CAMPBELL RD
Second Line	:	STE 200
City	:	DALLAS
State	:	TX
Zip	:	75252-5212
Country	:	US
Telephone Number	:	214-305-8217
Fax Number	:

Provider Business Practice Location Address
First Line	:	17430 CAMPBELL RD
Second Line	:	STE 200
City	:	DALLAS
State	:	TX
Zip	:	75252-5212
Country	:	US
Telephone Number	:	214-305-8217
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2014
Last Update Date	:	04/13/2017

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