Individual
NIKKOLE WEISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 990-5012
Mailing address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C011085
NC
Other
Enumeration date
04/02/2018
Last updated
09/20/2023
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