Individual
NICOLE RENEA NETHERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6691 W LEGACY LN, ELLETTSVILLE, IN 47429-9267
(812) 272-0591
Mailing address
6691 W LEGACY LN, ELLETTSVILLE, IN 47429-9267
(812) 272-0591
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34008563A
IN
Other
Enumeration date
02/11/2022
Last updated
02/11/2022
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