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Provider Information for 1396392049


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Mrs. NICOLE KRISTINE OUTTEN MSW, LCSW


Sex: Female

NPI: 1396392049
Last Updated: 2019-08-19
Certification Date:

Details

NameValue
NPI1396392049
Enumeration Date2019-08-19
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 1307 PHILADELPHIA PIKE
WILMINGTON, DE 19809-1821
United States

Phone: 302-746-7265 | Fax:302-746-7343
 
Primary Practice Address 1307 PHILADELPHIA PIKE
WILMINGTON, DE 19809-1821
United States

Phone: 302-746-7265 | Fax:302-746-7343
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - ClinicalDEQ1-0001715