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Individual

AMANDA JANE NICKERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
103 W 3RD ST # E, KALKASKA, MI 49646-5107
(231) 313-1882
Mailing address
2795 PINERIDGE CT NW APT C, GRAND RAPIDS, MI 49534-7511
(231) 313-1882

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
01/15/2025
Last updated
01/15/2025
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