Individual
MRS. KEMI A FABODE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
26921 KITCH ST, INKSTER, MI 48141-2515
(586) 770-6464
(586) 772-4089
Mailing address
51859 LILLIAN RD, CHESTERFIELD, MI 48047-3125
(586) 770-6464
(586) 772-4089
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
4703099353
MI
253J00000X
Foster Care Agency
AS820385058
MI
Other
Enumeration date
01/23/2019
Last updated
01/23/2019
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