Individual
REBECCA JAN NIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2386
(231) 935-7248
Mailing address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2386
(231) 935-7248
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101001576
MI
235Z00000X
Speech-Language Pathologist
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—
Other
Enumeration date
06/24/2019
Last updated
06/24/2019
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