Individual
MISS DORA KIDD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LBSW
Contact information
Practice address
12800 E WARREN AVE, DETROIT, MI 48215-2061
(313) 824-8000
(313) 824-5589
Mailing address
17546 GATEWAY CIR, SOUTHFIELD, MI 48075-4716
(248) 552-1552
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802071799
MI
Other
Enumeration date
03/22/2011
Last updated
03/22/2011
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