Individual
MRS. BETIANN KATHRINE WICHTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8586 28 MILE RD, WASHINGTON, MI 48094-1502
(586) 243-2669
Mailing address
8586 28 MILE RD, WASHINGTON, MI 48094-1502
(586) 243-2669
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
AF500086086
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45617887
—
MI
Enumeration date
02/02/2021
Last updated
02/02/2021
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