Organization
ABUNDANT LIFE COUNSELING & CONSULTING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NYCOLA ANN BOUCK LISW-S (OWNER/THERAPIST)
(419) 359-0307
Entity
Organization
Contact information
Practice address
348 MAIN ST, HURON, OH 44839-1610
(419) 359-0307
(833) 667-6490
Mailing address
348 MAIN ST, HURON, OH 44839-1610
(419) 359-0307
(833) 667-6490
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619188463
NPPES
OH
01
—
1700431277
NPPES
OH
Enumeration date
05/12/2020
Last updated
05/12/2020
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