Individual
KELLY RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1616 MIDLAND BLVD, ROYAL OAK, MI 48073-5601
(248) 229-3740
Mailing address
1616 MIDLAND BLVD, ROYAL OAK, MI 48073-5601
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/27/2023
Last updated
03/27/2023
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