Individual
JONATHA NISAN NATHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLC
Contact information
Practice address
625 E BIG BEAVER RD STE 200, TROY, MI 48083-1434
(586) 863-4000
Mailing address
407 MAXWELL AVE, ROYAL OAK, MI 48067-4606
(917) 406-7036
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6451023021
MI
Other
Enumeration date
01/29/2024
Last updated
01/29/2024
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