Individual
SHANIQUE IVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
29701 6 MILE RD STE 150A, LIVONIA, MI 48152-8604
(586) 229-0570
Mailing address
29701 6 MILE RD STE 150A, LIVONIA, MI 48152-8604
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/09/2020
Last updated
09/09/2020
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