Individual
NICOLE LEE BASCHLEBEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
37 N 6TH ST, COTTAGE GROVE, OR 97424-2012
(541) 623-6053
Mailing address
1345 BIRCH AVE, COTTAGE GROVE, OR 97424-1416
(541) 942-3939
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L11301
OR
Other
Enumeration date
01/21/2011
Last updated
08/07/2024
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