| Doctor Name: | LAURIANNE NICHOLS |
| NPI Number: | 1740338995 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 2738-123 |
| Business Practice Address: | 2450 Vineyard Dr Plover, WI - 544673973 |
| Business Phone Number: | 7153420290 |
| Business Fax Number: | 7153420291 |
| Mailing Address: | W5807 Glen Ave, ENDEAVOR |
| State: | WI |
| Postal Code: | 539309552 |
| Phone Number: | 6085872556 |
| Fax Number: | |
| NPI Enumeration Date: | 01/06/2007 |
| NPI Last Update Date: | 03/14/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 2738-123 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |