Individual
TRESA DIANE FORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25900 GREENFIELD RD STE 326, OAK PARK, MI 48237-1297
(877) 488-9724
Mailing address
25900 GREENFIELD RD STE 326, OAK PARK, MI 48237-1297
(877) 488-9724
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
F600802143635
MI
372500000X
Chore Provider
—
—
374700000X
Technician
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
06/09/2019
Last updated
06/09/2019
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