Individual
ELLIOT COLE NUCKOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPS
Contact information
Practice address
700 COMMERCE DR STE 250, WOODBURY, MN 55125-5407
(270) 268-1835
Mailing address
10 E 18TH ST UNIT 615, MINNEAPOLIS, MN 55403-4094
(270) 268-1835
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3675
MN
Other
Enumeration date
10/16/2021
Last updated
03/29/2023
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