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1629544978
MAUDE LAVERNE NICKOLOFF
YAKIMA, WA
NPI
1629544978
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2018-10-15
Last Update Date
2018-10-15
Business Address
MAUDE LAVERNE NICKOLOFF CDP
2280 WA-821
YAKIMA, WA 98901
Phone number: 509-457-0990
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Mailing Address
MAUDE LAVERNE NICKOLOFF CDP
PO BOX 217
SELAH, WA 98942-0217
Phone number:
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