Individual provider · Type 1 NPI

Nicole Theiss, MA

Professional Counselor · Edwardsville, IL

NPI number 1144766908 Active

Practice location

40B Edwardsville Prof Park
Edwardsville, IL 62025-3602

Call (618) 248-2040 Map

Fax (618) 248-2040

Mailing address

PO Box 101
Edwardsville, IL 62025-0101

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X178.010261 (IL)

Professional Counselor: Definition to come...

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About NPI 1144766908

Nicole Theiss, MA's National Provider Identifier is 1144766908, issued on Jan 17, 2017. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Edwardsville, IL. The record was last updated on Jan 17, 2017.