Individual
MS. NICOLE LEIGH HARTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
236 SIMPSON AVE, ELKHART, IN 46516-4666
(574) 293-0052
(574) 293-1739
Mailing address
236 SIMPSON AVE, ELKHART, IN 46516-4666
(574) 293-0052
(574) 293-1739
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006995A
IN
1041C0700X
Clinical Social Worker
6801089337
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34006995A
LICENSE
IN
Enumeration date
08/29/2011
Last updated
09/20/2018
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