Individual
NICOLE S DESMARTEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
215 W CHERRY ST, CHANUTE, KS 66720-1756
(620) 432-5180
Mailing address
215 W CHERRY ST, CHANUTE, KS 66720-1756
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW 6259
KS
Other
Enumeration date
10/04/2007
Last updated
10/04/2007
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