Individual
TABITHA NYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 STEVENS ST SW, GRAND RAPIDS, MI 49507-1526
(855) 832-6727
Mailing address
120 STEVENS ST SW, GRAND RAPIDS, MI 49507-1526
(269) 389-9102
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
07/08/2021
Last updated
02/05/2025
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