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Nicholl Olivares Rodriguez, PPC
Counselor in Jackson, Wyoming
NPI 1740898303

Nicholl Olivares Rodriguez is a Counselor based in Jackson, WY. Nicholl Olivares Rodriguez practices in Jackson, WY and has the professional credentials of PPC. The NPI Number for Nicholl Olivares Rodriguez is 1740898303 and holds a License No. PPC-1196 (Wyoming).

The current practice location address for Nicholl Olivares Rodriguez is 140 E Broadway Ave # B-13, Jackson, WY and can be reached out via phone at 307-413-6528. You can also correspond with Nicholl Olivares Rodriguez through the mailing address at 825 HI COUNTRY DR, JACKSON, WY - 83001-9442 (mailing address contact number: 307-699-4865).

Location: 140 E Broadway Ave # B-13, Jackson, WY, 83001-9442
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1740898303
Provider Name
Nicholl Olivares Rodriguez
Credential
PPC
Provider Entity Type
Individual
Gender
Female
Address
140 E Broadway Ave # B-13, Jackson, WY, 83001-9442
Phone Number
307-413-6528
Fax Number
Provider Enumeration Date
07/20/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
140 E Broadway Ave # B-13
City
Jackson
State
Wyoming
Zip
83001-8632
Phone Number
307-413-6528
Fax Number
person
Provider Business Mailing Address Details
Address
825 Hi Country Dr
City
Jackson
State
Wyoming
Zip
83001-9442
Phone Number
307-699-4865
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
PPC-1196 (Wyoming)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
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