Individual
MS. NICOLE MICHELLE CHAMBERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22958 W. GARDENIA DRIVE, BUCKEYE, AZ 85326
(480) 438-5338
(520) 296-8244
Mailing address
22958 W GARDENIA DRIVE, BUCKEYE, AZ 85326
(480) 438-5338
(520) 296-8244
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
385H00000X
Respite Care
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8H4949
AZ DHS
AZ
Enumeration date
08/24/2010
Last updated
01/13/2017
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