Individual
MRS. AMANDA LEE IACONELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17145 WOOD ST, MELVINDALE, MI 48122-1044
(734) 666-8325
Mailing address
17145 WOOD ST, MELVINDALE, MI 48122-1044
(734) 666-8325
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
04/04/2024
Last updated
04/04/2024
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