Individual
NICHOLE VIRNETTA SPAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED
Contact information
Practice address
6930 N BROAD ST APT B3, PHILADELPHIA, PA 19126-1709
(215) 264-9154
Mailing address
6930 N BROAD ST APT B3, PHILADELPHIA, PA 19126-1709
(215) 264-9154
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/28/2019
Last updated
06/28/2019
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