Individual
DR. NICOLE SEBASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, CCS, CADC
Contact information
Practice address
28466 HOOVER RD APT 1, WARREN, MI 48093-5419
(310) 467-6199
Mailing address
28466 HOOVER RD APT 1, WARREN, MI 48093-5419
(310) 467-6199
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6352000089
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500371
—
MI
Enumeration date
10/07/2008
Last updated
04/14/2022
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