Individual
NICOLE STREETS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
551 W LANCASTER AVE, HAVERFORD, PA 19041-1419
(610) 526-1974
Mailing address
549 E HIGH ST APT 2, PHILADELPHIA, PA 19144-1141
(267) 235-2039
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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