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General NPI Number Information
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NPI Number | 1205864725
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Entity Type | Individual
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Provider Name | MIRIAM ANNETTE NICHOLS L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3050 BISCAYNE BLVD SUITE 908
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City | MIAMI
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State | FL
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Zip | 33137-4158
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Country | US
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Telephone | 305-788-3729
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Fax | 305-535-8215
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Provider Business Mailing Address
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Address Line | 1210 LENOX AVE
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City | MIAMI BEACH
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State | FL
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Zip | 33139-3806
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Country | US
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Telephone | 305-788-3729
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Fax | 305-535-8215
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW 4681
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License Number State | FL
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