Siddoway, Nicole Denise
Siddoway, Nicole Denise is an sole proprietor health care provider with primary practice located at 530 E 34Th St Suite 102, Joplin MO 64804-3924. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Siddoway, Nicole Denise can be contacted via phone (417) 347-7500.Contact Information
Primary practice address
530 E 34Th St Suite 102
Joplin MO 64804-3924
Phone: (417) 347-7500
Fax: (417) 347-7508
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 2007035690 | Missouri |
Profile Details
| NPI number | 1659403731 |
|---|---|
| LBN Legal business name | Siddoway, Nicole Denise |
| Credentials | MA, LPC, CAC II |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 12th, 2007 |
| Last updated | Jun 26th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659403731 | NPPES |
| Missouri | MEDICAID | 497011205 |
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