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General NPI Number Information
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NPI Number | 1346094828
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Entity Type | Individual
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Provider Name | CAMBRIDGE NICHOLS LPC
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Gender | Female
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Dates
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Enumeration Date | 04/12/2024
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Last Update Date | 04/12/2024
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Provider Practice Location Address
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Address Line | 2207 N MAIN ST
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City | TAYLOR
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State | TX
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Zip | 76574-1829
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Country | US
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Telephone | 512-522-3507
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Fax |
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Provider Business Mailing Address
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Address Line | 11401 US HIGHWAY 290 E UNIT 360
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City | MANOR
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State | TX
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Zip | 78653-8017
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Country | US
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Telephone |
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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 | 86024
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License Number State | TX
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