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General NPI Number Information
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NPI Number | 1861314056
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Entity Type | Individual
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Provider Name | TAMMY GRACE NICHOLES MA, LMFT-ASSOCIATE
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Gender | Female
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Dates
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Enumeration Date | 07/28/2026
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Last Update Date | 07/28/2026
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Provider Practice Location Address
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Address Line | 808 JOHN PAUL JONES DR
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City | TEMPLE
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State | TX
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Zip | 76504-2264
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Country | US
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Telephone | 254-340-4228
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 144
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City | TEMPLE
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State | TX
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Zip | 76503-0144
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Country | US
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Telephone | 254-340-4228
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 203720
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License Number State | TX
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