Individual
AUTUMN NICOLE WHITESIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLMSW
Contact information
Practice address
882 OAKMAN BLVD STE D, DETROIT, MI 48238-4019
(313) 961-7990
(313) 883-6261
Mailing address
27225 DEVONSHIRE ST, SOUTHFIELD, MI 48076-5639
(248) 390-0956
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6851107419
MI
Other
Enumeration date
07/29/2021
Last updated
07/29/2021
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