Individual
NIKEYLA BLAKENEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15384 FREELAND ST, DETROIT, MI 48227-2911
(313) 758-9151
Mailing address
15384 FREELAND ST, DETROIT, MI 48227-2911
(313) 758-9151
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
320700000X
MI
Other
Enumeration date
08/15/2016
Last updated
08/15/2016
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