Individual
NICOLE PRENTICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSWAIC
Contact information
Practice address
1021 W BROADWAY AVE, MOSES LAKE, WA 98837-2604
(509) 750-0304
Mailing address
2848 ROAD 14.1 NW, EPHRATA, WA 98823-7822
(509) 750-0304
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SC61034969
WA
Other
Enumeration date
03/14/2020
Last updated
03/14/2020
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