Provider Demographics
NPI:1043070022
Name:NICHOLS, SHILA (NLP PRACTITIONER)
Entity type:Individual
Prefix:
First Name:SHILA
Middle Name:
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:NLP PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 75
Mailing Address - Street 2:
Mailing Address - City:ORONOGO
Mailing Address - State:MO
Mailing Address - Zip Code:64855-0075
Mailing Address - Country:US
Mailing Address - Phone:417-483-0295
Mailing Address - Fax:
Practice Address - Street 1:101 W 4TH ST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:MO
Practice Address - Zip Code:64755
Practice Address - Country:US
Practice Address - Phone:417-483-0295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 171400000X
CA6222405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No405300000XOther Service ProvidersPrevention Professional