Individual
DAX JOSEPH NICOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, CDP, MAC
Contact information
Practice address
1960 THOMPSON DR, SEDRO WOOLLEY, WA 98284-5007
(360) 856-3186
Mailing address
1960 THOMPSON DR, SEDRO WOOLLEY, WA 98284-5007
(360) 856-3186
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP00004631
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
MAC502067
DC
Other
Enumeration date
09/20/2016
Last updated
09/20/2016
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