Individual
NICOLE ALAYNA DOUGLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
816 E MICHIGAN AVE STE 103, PAW PAW, MI 49079-1462
(269) 815-8169
Mailing address
24213 OAK LN, MATTAWAN, MI 49071-9515
(269) 599-3168
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401020202
MI
Other
Enumeration date
04/12/2023
Last updated
04/12/2023
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