Individual
CYNDI NICHOLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1657 S GETTY ST, MUSKEGON, MI 49442-5872
(231) 343-2753
Mailing address
1657 S GETTY ST, MUSKEGON, MI 49442-5872
(231) 343-2753
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
MI
171W00000X
Contractor
—
MI
172V00000X
Community Health Worker
Primary
—
MI
251B00000X
Case Management Agency
—
MI
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
MI
251X00000X
Supports Brokerage Agency
—
MI
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376866160
—
MI
Enumeration date
01/13/2015
Last updated
01/13/2015
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