Individual
JENNIFER GRACIA VILLELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2799 W GRAND BLVD # K9, DETROIT, MI 48202-2608
(313) 916-4920
Mailing address
15960 ALPINE DR, LIVONIA, MI 48154-2542
(734) 679-4015
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601008182
MI
Other
Enumeration date
05/04/2017
Last updated
01/05/2026
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