Individual
MRS. GRETA AMARIS NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBASW
Contact information
Practice address
3847 PINE GROVE AVE, SUITE A, FORT GRATIOT, MI 48059-4265
(810) 966-3736
Mailing address
2124 WHITE ST, PORT HURON, MI 48060-5536
(810) 966-3736
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802084604
MI
Other
Enumeration date
08/09/2006
Last updated
07/08/2007
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