Individual
NICHOLAS E HARTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
94 BAYBERRY LOOP S, PURVIS, MS 39475-3460
(601) 705-1901
Mailing address
94 BAYBERRY LOOP S, PURVIS, MS 39475-3460
(601) 705-1901
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
780
MS
Other
Enumeration date
08/12/2009
Last updated
08/12/2009
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