Individual
NICOLE CLEVELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
551 HUCKLEBERRY BUTTE RD, OROFINO, ID 83544-5083
(208) 827-6093
Mailing address
551 HUCKLEBERRY BUTTE RD, OROFINO, ID 83544-5083
(208) 827-6093
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW43411
ID
Other
Enumeration date
04/11/2023
Last updated
04/11/2023
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