Individual
NICOLE SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DP
Contact information
Practice address
1619 W M 32, GAYLORD, MI 49735-9287
(231) 535-2822
(231) 535-2376
Mailing address
2329 CENTER ST, BOYNE FALLS, MI 49713-9268
(231) 535-2822
(231) 535-2376
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/02/2023
Last updated
02/02/2023
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