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Carly Jane Nicolau
Peer Specialist in Bend, Oregon
NPI 1841076742

Carly Jane Nicolau is a Peer Specialist based in Bend, OR. Carly Jane Nicolau practices in Bend, OR. The NPI Number for Carly Jane Nicolau is 1841076742 and holds a License No. 23-CRM-2333 (Oregon).

The current practice location address for Carly Jane Nicolau is 23 Nw Greenwood Ave, Bend, OR and can be reached out via phone at 541-383-4293.

Location: 23 Nw Greenwood Ave, Bend, OR, 97701-6160
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1841076742
Provider Name
Carly Jane Nicolau
Credential
Provider Entity Type
Individual
Gender
Female
Address
23 Nw Greenwood Ave, Bend, OR, 97701-6160
Phone Number
541-383-4293
Fax Number
Provider Enumeration Date
09/06/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
23 Nw Greenwood Ave
City
Bend
State
Oregon
Zip
97703-2078
Phone Number
541-383-4293
Fax Number
person
Provider Business Mailing Address Details
Address
23 Nw Greenwood Ave
City
Bend
State
Oregon
Zip
97703-2078
Phone Number
541-383-4293
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
23-CRM-2333 (Oregon)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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