Individual
MS. KENYETTA MYSHAWN COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ADMINISTRATOR
Contact information
Practice address
16087 MEADOWOOD AVE, SOUTHFIELD, MI 48076-4739
(248) 467-1142
Mailing address
16087 MEADOWOOD AVE, SOUTHFIELD, MI 48076-4739
(248) 467-1142
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
AS630405536
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000000000
—
MI
Enumeration date
04/10/2021
Last updated
04/02/2024
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