Individual
NICHOL A BOBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED, PCC-S
Contact information
Practice address
400 LAKEVIEW DR UNIT 206, WILDER, KY 41071-5310
(859) 816-7475
Mailing address
400 LAKEVIEW DR UNIT 206, WILDER, KY 41071-5310
(859) 816-7475
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1268
KY
101YP2500X
Professional Counselor
E.8044-SUPV
OH
Other
Enumeration date
03/02/2011
Last updated
03/02/2011
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