Dezary Rose Nichols

NPI #1912602244 in Standish, Michigan

Provider Information

NPI Number: 1912602244
Entity Type: Individual
Name: Dezary Rose Nichols
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Apr 4, 2023
Last Updated: Apr 4, 2023

Practice Location

Address: 3727 DEEP RIVER RD
City: Standish
State: Michigan
ZIP Code: 48658-9458
Phone: (989) 718-3146

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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