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Individual

NICOLE BROWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
3250 36TH ST SE, GRAND RAPIDS, MI 49512-8193
(616) 942-7294
Mailing address
2215 29TH ST SE STE B8A, GRAND RAPIDS, MI 49508-1565
(616) 690-5396

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401017587
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
CV0154400
MI
Enumeration date
02/06/2015
Last updated
03/11/2022
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