Individual
MRS. NICOLE MARIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
2251 E PARIS AVE SE, GRAND RAPIDS, MI 49546-2431
(616) 447-7799
Mailing address
2061 ONTARIO AVE NE, GRAND RAPIDS, MI 49505-4470
(616) 581-5379
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101004110
MI
Other
Enumeration date
05/16/2016
Last updated
05/16/2016
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