Individual
MS. NICOLETTE RE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, ACSW
Contact information
Practice address
20121 N 76TH ST UNIT 2057, SCOTTSDALE, AZ 85255-3872
(480) 677-1198
Mailing address
20121 N 76TH ST UNIT 2057, SCOTTSDALE, AZ 85255-3872
(480) 677-1198
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-12205
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCSW-12205
CLINICAL SOCIAL WORK LICENSE
AZ
Enumeration date
10/21/2009
Last updated
10/21/2009
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