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NPI 1750960613 · on the registry since 2021 · sole proprietor
Practice
- Address
- 29140 Pointe O Woods Pl Apt 101
Southfield, MI 48034 - Phone
- (734) 239-2670
Registry record
- Primary taxonomy
- 164W00000X
164W00000X
- Also registered as
- 253Z00000X
372600000X - Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-04-06
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