Individual
KOURTENAY CALDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLBSW
Contact information
Practice address
14799 DIX TOLEDO RD, SOUTHGATE, MI 48195-2507
(734) 324-8326
(734) 324-8327
Mailing address
9930 SUSSEX ST, DETROIT, MI 48227-2010
(313) 778-8727
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
L2551540
MI
Other
Enumeration date
11/08/2013
Last updated
11/08/2013
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