Individual
DIESHA MICHELLE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2399 E WALTON BLVD, AUBURN HILLS, MI 48326-1955
(248) 475-6400
(248) 475-6403
Mailing address
53 MARSTON ST APT 109, DETROIT, MI 48202-2583
(313) 858-7017
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/15/2023
Last updated
06/30/2023
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