Individual
NICOLE JEAN DE VERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3253 19TH ST NW STE 1, ROCHESTER, MN 55901-6794
(507) 218-2424
Mailing address
3253 19TH ST NW STE 1, ROCHESTER, MN 55901-6794
(507) 218-2424
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/30/2019
Last updated
08/30/2019
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