Individual
MICHELLE L NILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16 PHILLIPS ST, MASSENA, NY 13662-2016
(315) 764-8076
Mailing address
16 PHILLIPS ST, MASSENA, NY 13662-2016
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/17/2021
Last updated
04/26/2024
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