Individual
KRYSTAL ADAMS MACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA, SST
Contact information
Practice address
3646 MOUNT ELLIOTT ST, DETROIT, MI 48207-2311
(313) 331-3435
Mailing address
19712 SANTA BARBARA DR, DETROIT, MI 48221-1649
(313) 454-8158
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
6803088634
MI
Other
Enumeration date
02/25/2022
Last updated
02/25/2022
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