Individual
NICOLE KETOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 W SPRING ST, MARQUETTE, MI 49855-4661
(906) 225-7210
Mailing address
114 CONSTELLATION ST, GWINN, MI 49841-2725
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/24/2019
Last updated
01/24/2019
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