Individual
MRS. NICKIE LYNN COSGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
160 DOGWOOD LANE, MOUNTAIN HOME, TN 37684
(423) 926-1171
(423) 979-2645
Mailing address
PO BOX 4000, MOUNTAIN HOME, TN 37684-4000
(423) 926-1171
(423) 979-2645
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7581
TN
Other
Enumeration date
01/23/2009
Last updated
01/23/2009
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