Provider Information for 1588810196
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ASHLEY NICOLE HOLLAND JAGGI LCSW
Sex: Female
NPI: 1588810196
Last Updated: 2023-10-03
Certification Date: 2023-10-03
Certification Date: 2023-10-03
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1588810196 | ||||||||
| Enumeration Date | 2008-08-14 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 610 SE DILKE ST PULLMAN, WA 99163-2349 United States Phone: 801-660-9922 | Fax: | ||||||||
| Primary Practice Address | 610 SE DILKE ST PULLMAN, WA 99163-2349 United States Phone: 801-660-9922 | Fax: | ||||||||
| Secondary Practice Address(es) | 3392 W 3500 S 3535 S RICHEY BLVD | ||||||||
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