Individual
LAUREN NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1310 9TH AVE, LEWISTON, ID 83501-3104
(208) 413-1809
Mailing address
1310 9TH AVE, LEWISTON, ID 83501-3104
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
26691
ID
Other
Enumeration date
02/27/2015
Last updated
02/27/2015
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