Individual
NICOLE HIATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1015 MICHIGAN AVE, LOGANSPORT, IN 46947-1526
(574) 722-5151
(574) 739-1414
Mailing address
800 FULTON ST, ATTN: ANNE LAWSON - CREDENTIALING, LOGANSPORT, IN 46947-1577
(574) 205-2600
(574) 739-1414
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
34007391A
IN
Other
Enumeration date
06/17/2011
Last updated
01/26/2016
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