Individual
NICHOLAS DANIEL PECENICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADAC II
Contact information
Practice address
1141 16TH ST, BEDFORD, IN 47421-3721
(812) 558-0574
Mailing address
11175 PR 900 W, POLAND, IN 47868
(219) 613-8620
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C2-51280
IN
Other
Enumeration date
06/01/2022
Last updated
06/01/2022
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