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Individual
NICOLE J ULLOM
Active
Individual
NICOLE J ULLOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RADT
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
R1510160623
CA
172V00000X
Community Health Worker
Primary
—
CA
Other
Enumeration date
06/22/2023
Last updated
01/06/2025
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