Individual
ASHLEY NICOLE KEITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW LSW
Contact information
Practice address
1348 E STATE ROAD 124, WABASH, IN 46992-8044
(260) 563-5106
Mailing address
1348 E STATE ROAD 124, WABASH, IN 46992-8044
(260) 563-5106
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.0800834
OH
Other
Enumeration date
08/03/2010
Last updated
08/03/2010
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