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General NPI Number Information
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NPI Number | 1770035313
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Entity Type | Individual
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Provider Name | GEORGE NICHOLS PHD
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Gender | Male
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Dates
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Enumeration Date | 10/31/2016
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Last Update Date | 07/24/2019
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Provider Practice Location Address
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Address Line | 3326 DURHAM CHAPEL HILL BLVD STE 230
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City | DURHAM
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State | NC
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Zip | 27707-6239
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Country | US
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Telephone | 919-286-3453
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Fax |
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Provider Business Mailing Address
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Address Line | 409 PARKVIEW CRES
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City | CHAPEL HILL
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State | NC
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Zip | 27516-4443
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Country | US
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Telephone | 410-487-3457
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 4260
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License Number State | NC
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