Individual
NICOLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35425 W MICHIGAN AVE, WAYNE, MI 48184
(734) 722-5678
Mailing address
35425 W MICHIGAN AVE, WAYNE, MI 48184-9800
(734) 722-5678
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
MI
171M00000X
Case Manager/Care Coordinator
Primary
6802089293
MI
Other
Enumeration date
06/30/2015
Last updated
04/04/2019
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