Nicole Rae Quidort is a Clinical in Pontiac, Michigan. Nicole Rae Quidort practices all healthcare services and medical treatments related to Clinical. The NPI Number for Nicole Rae Quidort is 1659400505. The last update date is 2007-07-08.
Nicole Rae Quidort's current location address is 114 Orchard Lake Rd, Pontiac, Michigan. You can contact this provider via phone number 2488587766 and fax number 2488587201. The mailing address for Nicole Rae Quidort is 114 Orchard Lake Rd, Pontiac, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Nicole Rae Quidort |
|---|---|
| Address | 114 Orchard Lake Rd, Pontiac, Michigan |
| Phone Number | 2488587766 |
| Fax Number | 2488587201 |
| Sole Proprietor | N |
| Credentials | LLMSW |
NPI Number Detail
| NPI Number | 1659400505 |
|---|---|
| Provider Enumeration Date | 2007-03-05 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 114 Orchard Lake Rd |
|---|---|
| City | Pontiac |
| State | Michigan (MI) |
| Post Code | 483412244 |
| Phone Number | 2488587766 |
| Fax Number | 2488587201 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 6801086179 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1883825 | MI | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Nicole Rae Quidort by the Centers for Medicare & Medicaid Services?
The Nicole Rae Quidort has been issued the NPI (National Provider Identifier) 1659400505 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please share the complete physical location address where Nicole Rae Quidort's facilities are situated?
The facilities of Nicole Rae Quidort are physically located at the following address: 114 Orchard Lake Rd, Pontiac, MI, 483412244.
What is Nicole Rae Quidort's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Nicole Rae Quidort is Clinical, and the taxonomy classification code that categorizes this area of expertise is 1041C0700X.
On what date did the Nicole Rae Quidort receive its 1659400505 assignment from the Centers for Medicare & Medicaid Services?
The Nicole Rae Quidort was assigned its 1659400505 by the Centers for Medicare & Medicaid Services on 2007-03-05.
As of what date were the details related to Nicole Rae Quidort most recently updated or revised?
The information pertaining to Nicole Rae Quidort, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.