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Individual

NICOLE LEE HARRIMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
4884 MILLER TRUNK HWY STE 100, HERMANTOWN, MN 55811-2836
(218) 812-3600
(218) 309-0198
Mailing address
4884 MILLER TRUNK HWY STE 100, HERMANTOWN, MN 55811-2836
(218) 812-3600
(218) 309-0198

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
21375
MN
1041C0700X
Clinical Social Worker
21375
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1457693459
UBH-MEDICA
MN
05
1457693459
MN
Enumeration date
03/18/2013
Last updated
04/15/2021
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