MR. Jefferson Nichols JR., LBSW

NPI #1902146764 in Taylor, Michigan

Provider Information

NPI Number: 1902146764
Entity Type: Individual
Name: MR. Jefferson Nichols JR., LBSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Credential: LBSW
Enumeration Date: Feb 15, 2013
Last Updated: Feb 15, 2013

Practice Location

Address: 24354 ECORSE RD
City: Taylor
State: Michigan
ZIP Code: 48180-1643
Phone: (313) 292-5300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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