Individual
NICOLE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CIT
Contact information
Practice address
709 E NORTH PL, AMITE, LA 70422-2307
(985) 289-5264
Mailing address
709 E NORTH PL, AMITE, LA 70422-2307
(985) 289-5264
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CIT-5440
LA
Other
Enumeration date
07/20/2024
Last updated
07/20/2024
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