| Doctor Name: | MS. RENEE MARIE NICHOLS |
| NPI Number: | 1386873396 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A. LLPC |
| License Number: | 6401010844 |
| Business Practice Address: | 5780 Green Rd Haslett, MI - 488409712 |
| Business Phone Number: | 5174104063 |
| Business Fax Number: | |
| Mailing Address: | 5780 Green Rd, HASLETT |
| State: | MI |
| Postal Code: | 488409712 |
| Phone Number: | 5174104063 |
| Fax Number: | |
| NPI Enumeration Date: | 07/11/2009 |
| NPI Last Update Date: | 07/11/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 6401010844 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |