Individual
NICOLE VAN DRISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 CALLOWHILL ST STE 101, PHILADELPHIA, PA 19123-3658
(215) 825-8220
Mailing address
1200 CALLOWHILL ST STE 101, PHILADELPHIA, PA 19123-3658
(215) 825-8220
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/31/2018
Last updated
07/31/2018
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