Individual
MRS. NICOLE RENE J STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, CSWA
Contact information
Practice address
2001 NW NEWCASTLE ST, ROSEBURG, OR 97471-1657
(541) 492-2087
Mailing address
582 GLENGARY LOOP RD, ROSEBURG, OR 97470-8442
(425) 870-2523
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
A15038
OR
Other
Enumeration date
03/28/2024
Last updated
03/28/2024
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