Individual
KIMYETTA RUSSAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18718 NORTHLAWN ST, DETROIT, MI 48221-2088
(313) 204-7067
Mailing address
18718 NORTHLAWN ST, DETROIT, MI 48221-2088
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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