Individual
NICOLE HART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1109 JONES ST, KENNETT, MO 63857-3824
(573) 888-6545
Mailing address
1109 JONES ST, KENNETT, MO 63857-3824
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/23/2015
Last updated
06/23/2015
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