Individual
NICCOL MARIE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
5000 W NATIONAL AVE, MILWAUKEE, WI 53295-0001
(414) 384-2000
Mailing address
5000 W NATIONAL AVE, MILWAUKEE, WI 53295-0001
(414) 384-2000
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
127247-121
WI
1041C0700X
Clinical Social Worker
Primary
7623-123
WI
Other
Enumeration date
06/18/2007
Last updated
12/13/2010
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