Individual
MRS. NICOLE RASMUSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
9601 MAIN ST, HOLLAND PATENT, NY 13354-4618
(315) 865-8151
Mailing address
9601 MAIN ST, HOLLAND PATENT, NY 13354-4618
(315) 865-8151
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
73 084812
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01390578
—
NY
Enumeration date
10/19/2016
Last updated
10/19/2016
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