Individual
JESSICA KANDALAFT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLMSW
Contact information
Practice address
11480 E 13 MILE RD, WARREN, MI 48093-2566
(586) 216-9253
Mailing address
14740 HIX ST, LIVONIA, MI 48154-4812
(734) 377-8004
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801105592
MI
Other
Enumeration date
08/23/2020
Last updated
08/23/2020
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