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General NPI Number Information
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NPI Number | 1326836495
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Entity Type | Individual
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Provider Name | EMMA GRACE NICHOLSON M.ED.
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Gender | Female
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Dates
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Enumeration Date | 04/29/2025
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 5975 PKWY NORTH BLVD STE D
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City | CUMMING
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State | GA
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Zip | 30040-8255
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Country | US
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Telephone | 404-388-3909
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Fax |
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Provider Business Mailing Address
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Address Line | 1206 SUMMIT PLACE DR UNIT 6
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City | SANDY SPRINGS
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State | GA
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Zip | 30350-2436
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Country | US
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Telephone | 770-722-3553
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Fax |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | APC010634
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License Number State | GA
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