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NPI Code Detail

MEDICARE: NICOLE LESLIE-JEAN BURROWS

MEDICARE: NICOLE LESLIE-JEAN BURROWS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1659225407
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE LESLIE-JEAN BURROWS
Provider Business Mailing Address
First Line : 4234 CASCADE RD SE STE 3
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49546-8384
Country : US
Telephone Number : 888-614-4144
Fax Number :
Provider Business Practice Location Address
First Line : 4234 CASCADE RD SE STE 3
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49546-8384
Country : US
Telephone Number : 888-614-4144
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2026
Last Update Date : 02/26/2026

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Directions to “ NICOLE LESLIE-JEAN BURROWS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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