Individual
OLEESHA ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11313 WADE ST, DETROIT, MI 48213-1676
(313) 694-1590
Mailing address
18548 KINGSVILLE ST, HARPER WOODS, MI 48225-2136
(586) 935-7066
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000
DONT HAVE ANY
—
Enumeration date
11/12/2021
Last updated
07/21/2022
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