Individual
NICOLE ALICE JOY MARESCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1430 KNAPP ST NE, GRAND RAPIDS, MI 49505-4448
(616) 301-8000
Mailing address
1430 KNAPP ST NE, GRAND RAPIDS, MI 49505-4448
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0004266624
—
MI
Enumeration date
09/20/2017
Last updated
09/20/2017
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