Individual
NICOLE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC ACS
Contact information
Practice address
60 W LANDIS AVE, VINELAND, NJ 08360-8107
(856) 772-5809
Mailing address
12 S MAPLE AVE APT 310, MARLTON, NJ 08053-2217
(732) 379-7398
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
37AC00380400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37AC00380400
—
NJ
Enumeration date
09/28/2017
Last updated
10/18/2024
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