Edie Nicholson, PCMHT

NPI #1295507879 in Ellisville, Mississippi

Provider Information

NPI Number: 1295507879
Entity Type: Individual
Name: Edie Nicholson, PCMHT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Credential: PCMHT
Enumeration Date: Oct 26, 2023
Last Updated: Oct 26, 2023

Practice Location

Address: 5192 HIGHWAY 11 N
City: Ellisville
State: Mississippi
ZIP Code: 39437-5050
Phone: (601) 649-7921

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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