Cory John Nichols

NPI #1245448901 in Bridgeton, Missouri

Provider Information

NPI Number: 1245448901
Entity Type: Individual
Name: Cory John Nichols
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Enumeration Date: May 18, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 3165 MCKELVEY RD
Address 2: SUITE 200
City: Bridgeton
State: Missouri
ZIP Code: 63044-2550
Phone: (314) 206-3900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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