Individual
NICOLE MARIE HOLYFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16000 MIDDLEBELT RD, LIVONIA, MI 48154-3359
(734) 524-0378
(734) 524-0379
Mailing address
16000 MIDDLEBELT RD, LIVONIA, MI 48154-3359
(734) 524-0378
(734) 524-0379
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251C00000X
—
MI
05
—
261QA0600X
—
MI
05
—
385H00000X
—
MI
Enumeration date
04/18/2017
Last updated
04/18/2017
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