Individual
MR. WILLIAM G NICK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
620 N 12TH AVE, STURGEON BAY, WI 54235-1249
(920) 743-9954
Mailing address
620 N 12TH AVE, STURGEON BAY, WI 54235-1249
(920) 743-9954
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
39205900
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39205900
—
WI
Enumeration date
02/24/2006
Last updated
07/08/2007
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