Individual
NICOLE COCKRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1880 AUSTIN RD, OWATONNA, MN 55060-4543
(507) 202-4158
Mailing address
1880 AUSTIN RD, OWATONNA, MN 55060-4543
(507) 202-4158
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
22455
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831739788
NPI II
MN
Enumeration date
07/12/2018
Last updated
09/18/2023
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