Individual
TATIANA MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15491 HEYDEN ST, DETROIT, MI 48223-1746
(313) 618-3502
Mailing address
15491 HEYDEN ST, DETROIT, MI 48223-1746
(313) 618-3502
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
0317202329043
MI
Other
Enumeration date
06/28/2023
Last updated
06/28/2023
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