Individual
BRIELLE NICOLE NAGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
1691 GRACE AVE, LEBANON, PA 17046-1506
(717) 228-0935
Mailing address
419 S 15TH ST, LEBANON, PA 17042-6516
(570) 573-5497
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08191995
INTERN
—
Enumeration date
11/12/2019
Last updated
11/12/2019
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