Individual
MS. NICOLE S IDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC, NCC
Contact information
Practice address
31815 SOUTHFIELD RD STE 18, BEVERLY HILLS, MI 48025-5471
(248) 480-0115
Mailing address
31815 SOUTHFIELD RD STE 18, BEVERLY HILLS, MI 48025-5471
(248) 480-0115
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401010396
MI
101YP2500X
Professional Counselor
6401010396
MI
Other
Enumeration date
09/14/2022
Last updated
09/26/2024
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