| Nicole Roubos, | |
|
2855 44th St Sw Ste 160, Grandville, MI 49418-2682 | |
| (616) 379-9887 | |
| Not Available |
| Full Name | Nicole Roubos |
|---|---|
| Gender | Female |
| Speciality | Speech-language Pathologist |
| Location | 2855 44th St Sw Ste 160, Grandville, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336841188 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 2222040101 (Michigan) | Primary |
| Provider Name | Thrive Pediatric Speech And Feeding Therapy, Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1265074827 PECOS PAC ID: 8325471873 Enrollment ID: O20191213002136 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Roubos, 11886 Seven Pine Dr, Holland, MI 49424-8673 Ph: (231) 499-1817 | Nicole Roubos, 2855 44th St Sw Ste 160, Grandville, MI 49418-2682 Ph: (616) 379-9887 |
Meghan Vandewater, CCC-SLP, C/NDT Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 2855 44th St Sw Ste 160, Grandville, MI 49418 Phone: 616-379-9887 | |
Mrs. Kathryn Antor, M.A., CCC-SLP Speech-Language Pathologist Medicare: Accepting Medicare Assignments Practice Location: 3010 Wilson Ave Sw, Grandville, MI 49418 Phone: 616-249-8141 Fax: 616-249-8147 | |
Mackenzie Galbreath, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2855 44th St Sw Ste 160, Grandville, MI 49418 Phone: 616-379-9887 | |
Ms. Molly Jane Hausbeck, Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 3010 Wilson Ave Sw, Grandville, MI 49418 Phone: 616-249-8141 | |
Anna Horn, MS, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 159 Brookmeadow North Ln Sw Apt 3, Grandville, MI 49418 Phone: 269-312-0049 | |
Theresa Eddie, MA, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2880 Wilson Ave Sw, Grandville, MI 49418 Phone: 616-300-5495 |