Individual
MISS KATHY THI Y NHI PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
29689 MARSHALL ST, SOUTHFIELD, MI 48076-5845
(248) 635-7414
Mailing address
29689 MARSHALL ST, SOUTHFIELD, MI 48076-5845
(248) 635-7414
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
06/05/2019
Last updated
06/05/2019
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