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Individual
NICOLE M. GAGNON
Active
Individual
NICOLE M. GAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LICSW124767
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110187601A
—
MA
Enumeration date
01/11/2022
Last updated
12/18/2023
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