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Individual

MRS. TINETRA EVETT-TAYLOR BURNS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, RSST, CAC-M

Contact information

Practice address
3850 12TH STREET, ECORSE, MI 48229-1319
(313) 693-2141
Mailing address
3850 12TH ST, ECORSE, MI 48229-1319
(313) 693-2141

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
6803085412
MI

Other

Enumeration date
04/12/2010
Last updated
04/12/2010
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