| NPI | 1790087807 |
|---|---|
| Former Name | NICOLE MARIE WEATHERMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NV CP0069) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NV 323-LC) |
| Enumeration Date | 2010-11-22 |
| Last Update Date | 2020-08-24 |