Individual
NICOLETTE ANNE MACDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APCC
Contact information
Practice address
1234 EMPIRE ST, FAIRFIELD, CA 94533-5711
(415) 755-8495
Mailing address
1234 EMPIRE ST, FAIRFIELD, CA 94533-5711
(510) 317-1444
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
11360
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/28/2012
Last updated
06/21/2024
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