Michelle L Niles
Peer Specialist in Massena, NY. Individual provider (NPI-1).
NPI number1003484841
StatusActive
Last updated in NPPESApr 26, 2024
Details
- NPI
- 1003484841
- Entity type
- Individual (NPI-1)
- Name
- Michelle L Niles
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 17, 2021
- Certification date
- Apr 26, 2024
- Last updated
- Apr 26, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | – | – | Yes |
Other names
- Michelle L Grimshaw (Former Name)
Practice location
16 Phillips StMassena, NY 13662-2016
Phone 315-764-8076
Mailing address
16 Phillips StMassena, NY 13662-2016
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