Individual
MICHELE NACKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
120 1/2 W MAIN ST, BOWLING GREEN, MO 63334-1642
(573) 470-2656
(417) 944-1440
Mailing address
18820 PIKE 9230, BOWLING GREEN, MO 63334-3853
(573) 324-2656
(417) 944-1440
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2011014526
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12677303
CAQH
—
05
—
1720376916
—
MO
01
—
1891115036
UPPER ROOM NPI
—
Enumeration date
07/21/2011
Last updated
05/16/2014
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