Individual
NICOLE LEE SIRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
1407 SAINT ANDREW ST STE 100, LA CROSSE, WI 54603-2378
(608) 785-6297
Mailing address
215 ASPEN ST., NEW ALBIN, IA 52160
(563) 544-4496
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
8694-120
WI
Other
Enumeration date
04/22/2009
Last updated
04/22/2009
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