Individual
BRYN NICOLE COTHRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1714 A ST, LA PORTE, IN 46350-5925
(219) 342-2415
Mailing address
414 WILSHIRE AVE, MICHIGAN CITY, IN 46360-6252
(219) 608-9053
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33012473A
IN
Other
Enumeration date
06/22/2026
Last updated
06/22/2026
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