Individual
RICKKEY MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12677 VIRGIL ST, DETROIT, MI 48223-3046
(313) 268-4387
Mailing address
12677 VIRGIL ST, DETROIT, MI 48223-3046
(313) 268-4387
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
6801104534
MI
247200000X
Other Technician
—
—
Other
Enumeration date
07/02/2015
Last updated
07/03/2019
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