Individual
CAROLE KAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
41795 W 12 MILE RD, NOVI, MI 48377-3107
(249) 449-1655
Mailing address
41795 W 12 MILE RD, NOVI, MI 48377-3107
(249) 449-1655
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704285697
MI
Other
Enumeration date
06/10/2021
Last updated
06/10/2021
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