Individual provider · Type 1 NPI

Jae Nicholson

Professional Counselor · Bryan, TX

NPI number 1619620176 Active

Practice location

2490 Boonville Rd
Bryan, TX 77808-2326

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X76655

Professional Counselor: Definition to come...

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About NPI 1619620176

Jae Nicholson's National Provider Identifier is 1619620176, issued on Feb 3, 2022. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Bryan, TX. The record was last updated on Feb 3, 2022.