Provider Demographics
NPI:1770810236
Name:NOLDA, NANCY C (MA)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:C
Last Name:NOLDA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 E BURGUNDY RD
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:WA
Mailing Address - Zip Code:98584-9430
Mailing Address - Country:US
Mailing Address - Phone:360-229-6880
Mailing Address - Fax:
Practice Address - Street 1:730 E BURGUNDY RD
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-9430
Practice Address - Country:US
Practice Address - Phone:360-229-6880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 00004649101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health