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Individual

TAWANNA Q KING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
18714 FORRER ST, DETROIT, MI 48235-2911
(313) 694-7770
Mailing address
18714 FORRER ST, DETROIT, MI 48235-2911
(313) 694-7770

Taxonomy

Speciality
Code
Description
License number
State
174200000X
Meals Provider
251E00000X
Home Health Agency
372500000X
Chore Provider
Primary
374U00000X
Home Health Aide

Other

Enumeration date
01/02/2023
Last updated
01/12/2023
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