Individual
NICOLE BUSHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4000 W SPENCER ST, APPLETON, WI 54914-4015
(920) 997-1399
(920) 735-9050
Mailing address
4000 W SPENCER ST, APPLETON, WI 54914-4015
(920) 997-1399
(920) 735-9050
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4360125
WI
Other
Enumeration date
03/29/2010
Last updated
03/29/2010
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