Shane Daniel Nicolas
NPI #1114597713 in Chesterfield, Michigan
Provider Information
- NPI Number
- 1114597713
- Entity Type
- Individual
- Name
- Shane Daniel Nicolas
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Behavior Technician
- Enumeration Date
- Jun 28, 2021
- Last Updated
- Jun 28, 2021
Practice Location
- Address
- 51145 NICOLETTE DR
- City
- Chesterfield
- State
- Michigan
- ZIP Code
- 48047-4585
- Phone
- (586) 228-9991
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Technician |
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