Individual
MARISLENE DELVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25420 GODDARD ROAD, TAYLOR, MI 48180
(313) 388-1666
Mailing address
11352 GABRIEL STREET, ROMULUS, MI 48174
(313) 575-8111
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
018640-1
NY
363A00000X
Physician Assistant
Primary
5601007382
MI
363A00000X
Physician Assistant
9108647
FL
Other
Enumeration date
07/01/2015
Last updated
07/01/2015
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