Individual
NICOVA P BURSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
720 MAPLE HILL CIR, RIPLEY, TN 38063-3913
(731) 326-0045
Mailing address
720 MAPLE HILL CIR, RIPLEY, TN 38063-3913
(731) 326-0045
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
13043
TN
101YM0800X
Mental Health Counselor
Primary
13043
TN
104100000X
Social Worker
13043
TN
Other
Enumeration date
05/22/2007
Last updated
11/09/2021
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