Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nicole R Skodack, CTRS

Individual provider Recreation Therapist · NPI 1235684986

Nicole R Skodack, CTRS is a Recreation Therapist in Grand Haven, Michigan. Registered with an NPI since 2016.

In the registry since
2016
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Practice location Address checks out

1719 Wisconsin Ave
Grand Haven, MI 49417-2576
Phone: (616) 540-4911
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Recreation Therapist (primary) Taxonomy 225800000X

Record details

NPI number1235684986
Entity typeIndividual (Type 1)
GenderFemale
Credentials CTRS
Sole proprietorNo
NPI enumeratedAugust 23, 2016
Last updated in NPPESAugust 23, 2016

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