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Individual

MRS. NICOLE LEA ROBERTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMFT, LCPC, PMH-C

Contact information

Practice address
4273 44TH AVE S, FARGO, ND 58104-3939
(701) 526-4885
Mailing address
4273 44TH AVE S, FARGO, ND 58104-3939
(701) 526-4885

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
BBH-LCPC-LIC-29694
MT
106H00000X
Marriage & Family Therapist
2015-051
ND
106H00000X
Marriage & Family Therapist
3473
MN

Other

Enumeration date
02/06/2017
Last updated
05/10/2023
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