Individual
NICOLE MARIE MCDAVID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT-BC
Contact information
Practice address
1907 45TH AVE NE, SALEM, OR 97305-2272
(925) 918-0329
Mailing address
1907 45TH AVE NE, SALEM, OR 97305-2272
(925) 918-0329
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
QMHA
OR
Other
Enumeration date
02/14/2009
Last updated
02/14/2009
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