Individual
MISS NICOLE ANNETTE COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
501 HIGHWAY J, HAYTI, MO 63851-1200
(573) 359-9840
Mailing address
501 HIGHWAY J, HAYTI, MO 63851-1200
(573) 359-9840
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2021030695
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490065062
—
MO
Enumeration date
12/16/2014
Last updated
08/11/2021
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