Individual
NICOLE NULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA/ST
Contact information
Practice address
1518 AIRPORT RD, HINESVILLE, GA 31313-9439
(912) 559-5536
(614) 388-3712
Mailing address
197 GROOVER RD NE, LUDOWICI, GA 31316-4811
(785) 477-5583
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/24/2023
Last updated
01/24/2023
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