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Individual

NICKOLE WOODS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
101 E EDWARDSVILLE RD, WOOD RIVER, IL 62095-1369
(618) 296-5390
Mailing address
88 S MAIN ST, GLEN CARBON, IL 62034-1415
(618) 288-8085
(618) 288-8959

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150106883
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4A00-IPI-032
IL
Enumeration date
08/23/2022
Last updated
08/23/2022
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