Individual
NICOLE DONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
45 N WHITTAKER ST STE 204, NEW BUFFALO, MI 49117-1173
(269) 235-9821
(269) 359-3735
Mailing address
300 W MICHIGAN ST, NEW BUFFALO, MI 49117-1370
(708) 921-5381
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
22006997A
IN
235Z00000X
Speech-Language Pathologist
242.002629
IL
235Z00000X
Speech-Language Pathologist
Primary
7101006661
MI
Other
Enumeration date
08/05/2013
Last updated
09/03/2023
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