Individual
DOMINIQUE PICKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCMA
Contact information
Practice address
2939 RUSSELL ST, DETROIT, MI 48207-4825
(313) 369-3500
(313) 567-1876
Mailing address
2939 RUSSELL ST, DETROIT, MI 48207-4825
(313) 369-3500
(313) 567-1876
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
MI
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
01/16/2015
Last updated
01/16/2015
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