Provider Information for 1215242987
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CHERI L NYEGAARD HOLBROOK LCSW
Sex: Female
NPI: 1215242987
Last Updated: 2010-08-24
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1215242987 | ||||||||
| Enumeration Date | 2010-08-18 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 1995 MADISON, MS 39130-1995 United States Phone: 601-695-1919 | Fax:601-420-5299 | ||||||||
| Primary Practice Address | 254 INGLESIDE DR MADISON, MS 39110-9524 United States Phone: 601-695-1919 | Fax:601-420-5299 | ||||||||
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