Nicole Ethridge's National Provider Identifier (NPI) Details
Nicole Ethridge, MA, LPC
NPI: 1760974596
Enumeration Date: 2018-06-06
Last updated: 2024-10-01
Sole Proprietor: NO
Status: active
Postal Address: 1805 E WALNUT ST, COLUMBIA, MO
Phone: 573-777-7500
Primary Practice Address: 1300 E BRADFORD PKWY, SPRINGFIELD, MO
Practice's phone: 417-761-5000