Individual
NICHOLE CHAMPAGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
13213 E 14 MILE RD, STERLING HEIGHTS, MI 48312
(586) 939-4374
Mailing address
53534 ASHLEY DR, NEW BALTIMORE, MI 48047-6356
(586) 713-6566
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164806618
—
MI
Enumeration date
07/15/2015
Last updated
05/17/2018
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