| NPI | 1669296042 |
|---|---|
| Other Name | NICOLE M IMMERFALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 31001) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 134023) |
| Enumeration Date | 2024-11-12 |
| Last Update Date | 2025-01-07 |