Individual
KELLY WHITTAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
16747 SHAFTSBURY AVE, DETROIT, MI 48219-4012
(313) 971-4318
Mailing address
16747 SHAFTSBURY AVE, DETROIT, MI 48219-4012
(313) 971-4318
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
11/20/2015
Last updated
11/20/2015
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