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Individual

JACOB NIDEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LSW

Contact information

Practice address
515 BAYOU ST, VINCENNES, IN 47591-1034
(812) 886-6800
(812) 886-6809
Mailing address
515 BAYOU ST, VINCENNES, IN 47591-1034
(812) 886-6800
(812) 886-6809

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33006476A
IN

Other

Enumeration date
12/07/2012
Last updated
12/07/2012
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