Individual
ELISE NICOLE HEADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1004 W 1ST ST, BLOOMINGTON, IN 47403-2208
(812) 393-5834
Mailing address
1004 W 1ST ST, BLOOMINGTON, IN 47403-2208
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
IN
Other
Enumeration date
07/13/2021
Last updated
07/13/2021
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