Individual
NICOLE FULLER-DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
375 APPLE TREE DR, IONIA, MI 48846-7506
(616) 527-1790
(616) 527-0538
Mailing address
375 APPLE TREE DR, IONIA, MI 48846-7506
(616) 527-1790
(616) 527-0538
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6451023748
MI
Other
Enumeration date
07/30/2024
Last updated
07/30/2024
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