Individual
NICKIE BUCHANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1506 MAIN RD, TIVERTON, RI 02878-4417
(910) 581-8079
Mailing address
1506 MAIN RD, TIVERTON, RI 02878-4417
(910) 581-8079
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/05/2016
Last updated
04/05/2016
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