Individual
NICOLE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
4934 LUXEMBURG ST SE, GRAND RAPIDS, MI 49546-8406
(616) 828-5492
(855) 206-3270
Mailing address
PO BOX 1053, ADA, MI 49301-1053
(616) 828-5492
(855) 206-3270
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
12/07/2017
Last updated
12/07/2017
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