Individual
NICOLE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1240 N BUTTERFIELD RD, BOLIVAR, MO 65613-3016
(417) 326-6021
Mailing address
1240 N BUTTERFIELD RD, BOLIVAR, MO 65613-3016
(417) 326-6021
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2023011709
MO
104100000X
Social Worker
Primary
2025049404
MO
Other
Enumeration date
08/18/2023
Last updated
05/04/2026
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