| NPI | 1073011136 |
|---|---|
| Former Name | NICOLE WADE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801111274) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2023-11-27 |