Provider Demographics
NPI:1699803072
Name:NICHOLLS, EMMA HAMILTON (BA)
Entity type:Individual
Prefix:MISS
First Name:EMMA
Middle Name:HAMILTON
Last Name:NICHOLLS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:881 ITHACA DR
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-5724
Mailing Address - Country:US
Mailing Address - Phone:720-308-3097
Mailing Address - Fax:
Practice Address - Street 1:980 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-6005
Practice Address - Country:US
Practice Address - Phone:303-449-8334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health