Individual
NICHOLETTI WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2302 MORELAND BLVD, CHAMPAIGN, IL 61822-1398
(217) 356-7576
Mailing address
1021 N MULFORD RD, ROCKFORD, IL 61107-3877
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/30/2019
Last updated
10/30/2019
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