Provider Demographics
NPI:1497505838
Name:SOUDERS, NICOLE S (AAC)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:S
Last Name:SOUDERS
Suffix:
Gender:F
Credentials:AAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 N COMMERCIAL ST STE 1400
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4437
Mailing Address - Country:US
Mailing Address - Phone:360-255-0958
Mailing Address - Fax:
Practice Address - Street 1:119 N COMMERCIAL ST STE 1400
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4437
Practice Address - Country:US
Practice Address - Phone:360-255-0958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor