Individual
NICOLE MANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
398 HINKS RD, JEFFERSON, ME 04348-4012
(207) 557-0395
Mailing address
398 HINKS RD, JEFFERSON, ME 04348-4012
(207) 557-0395
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MC16510
ME
1041C0700X
Clinical Social Worker
Primary
LC17825
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1851838635
NPI
—
Enumeration date
01/31/2017
Last updated
09/02/2019
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