Most Relevant Information
Provider Data
| NPI Number: | 1003484841 |
| Provider Name: | MICHELLE L NILES |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/17/2021 |
| Last Updated: | 04/26/2024 |
Provider Practice Location
16 PHILLIPS ST
MASSENA
NY
136622016
Practice Location Phone/Fax
| Phone: | 3157648076 |
| Fax: |
Provider Mailing Location
16 PHILLIPS ST
MASSENA
NY
136622016
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |