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NPI 1437824356 · on the registry since 2021 · sole proprietor
Practice
- Address
- 26450 Crocker Blvd Apt 622
Harrison Township, MI 48045 - Phone
- (586) 289-3403
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 101YA0400X
101YA0400X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-08-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan