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Individual

NICOLE BORDEAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
80 SHARRON AVE, PLATTSBURGH, NY 12901-4700
(518) 561-1447
Mailing address
79 GLENRIDGE RD, GLENVILLE, NY 12302-4528

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
36699-T
NY
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
39558
NY

Other

Enumeration date
08/11/2020
Last updated
08/21/2024
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