Individual
KYANNAH TOYANN ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
175 S.EDITH ST, PONTIAC, MI 48342
(567) 298-5332
(248) 622-4165
Mailing address
175 S EDITH ST, PONTIAC, MI 48342-3274
(567) 298-5332
(248) 622-4165
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1420720
—
MI
Enumeration date
06/17/2009
Last updated
02/28/2014
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