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General NPI Number Information
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NPI Number | 1316356074
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Entity Type | Individual
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Provider Name | NICOLE DEVOL LLPC
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Gender | Female
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Dates
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Enumeration Date | 08/07/2014
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Last Update Date | 06/15/2015
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Provider Practice Location Address
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Address Line | 3642 ORCHARD VW
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-8940
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Country | US
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Telephone | 231-409-1276
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 W 11TH ST #217
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-3287
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Country | US
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Telephone | 231-409-1276
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6401011969
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | PF0000000783549
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License Number State | MI
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