Individual
NICO Q SQUADRONI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1 PLAZA DR, #6, PENDLETON, IN 46064-8823
(765) 778-0380
(765) 778-8328
Mailing address
1 PLAZA DR, #6, PENDLETON, IN 46064-8823
(765) 778-0380
(765) 778-8328
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34005225A
IN
Other
Enumeration date
09/25/2006
Last updated
07/08/2007
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