Individual
MS. BONNIE NICOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
139 N MAIN ST, WEST HARTFORD, CT 06107-1264
(860) 570-1805
(866) 838-0440
Mailing address
139 N MAIN ST, WEST HARTFORD, CT 06107-1264
(860) 570-1805
(866) 838-0440
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
000515
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
240000515CT01
BLUE CROSS
CT
Enumeration date
03/21/2006
Last updated
04/28/2017
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