| NPI | 1508091646 |
|---|---|
| Former Name | NICOLETTE LEE SHAFFER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NE 1462) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA SW127142) |
| 1041C0700X Social Worker Clinical (Licence: PA CW017288) | |
| 101YM0800X Counselor Mental Health (Licence: NE 4099) | |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2012-08-16 |