Individual
NICOLE MARIE IVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
2004 HIGHLAND AVE STE M, EAU CLAIRE, WI 54701-4389
(715) 355-9158
(715) 835-8112
Mailing address
9000 W WISCONSIN AVE # MS 958, MILWAUKEE, WI 53226-4874
(414) 266-7615
(414) 266-6238
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1224-124
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801274931
—
WI
Enumeration date
05/08/2015
Last updated
01/07/2020
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