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Individual

CYNDI NICHOLES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

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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