Individual
NICOLE R FUGLSANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
130 CALO LN, LAKE OZARK, MO 65049-9208
(573) 365-2221
(573) 365-2221
Mailing address
5550 MING AVE, SUITE #265, BAKERSFIELD, CA 93309
(573) 365-2221
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2008018994
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2008018994
LICENSE
MO
Enumeration date
02/10/2025
Last updated
02/10/2025
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