Individual provider · NPI-1

Tekora Nichols, LCSW-C

Social Worker, Clinical · Belcamp, MD

NPI number1609264449
StatusActive
Last updated in NPPESJan 1, 2015

Details

NPI
1609264449
Entity type
Individual (NPI-1)
Name
Tekora Nichols
Credential
LCSW-C
Sex
Female
Sole proprietor
Yes
Enumeration date
Jan 1, 2015
Last updated
Jan 1, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical17336MDYes

Practice location

1307 Liatris Ln
Belcamp, MD 21017-1660

Phone 240-370-9479

Mailing address

1307 Liatris Ln
Belcamp, MD 21017-1660

Phone 240-370-9479

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