Individual
MEGAN NICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5900 BYRON CENTER AVE SW, WYOMING, MI 49519-9606
(941) 301-7263
Mailing address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7152000433
MI
Other
Enumeration date
01/16/2023
Last updated
10/31/2023
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