Individual
AMIR KAMAL BRACKEN SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, SST
Contact information
Practice address
2925 RUSSELL, DETROIT, MI 48207
(313) 396-5300
Mailing address
2925 RUSSELL ST, DETROIT, MI 48207-4825
(313) 396-5300
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
6803086950
MI
Other
Enumeration date
07/19/2017
Last updated
07/21/2022
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