Individual provider · Type 1 NPI

Kelley Anne Nicholson

Addiction (Substance Use Disorder) Counselor · Modesto, CA

NPI number 1962059832 Active

Practice location

1235 Mchenry Ave Ste A&b
Modesto, CA 95350-5370

Call (209) 527-4597 Map

Mailing address

4000 Tierra Lago Dr
Modesto, CA 95356-8743

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1962059832

Kelley Anne Nicholson's National Provider Identifier is 1962059832, issued on Aug 24, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Modesto, CA. The record was last updated on Aug 24, 2019.