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Individual

NICOLE HARTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7640 DIXIE HWY STE 155, CLARKSTON, MI 48346-2095
(248) 791-9266
Mailing address
7485 WHITE LAKE RD, WHITE LAKE, MI 48383-1160

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401225433
MI
101YP2500X
Professional Counselor
PC007649
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200912175
PA
Enumeration date
11/19/2014
Last updated
09/15/2025
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