Individual
JESSICA TOODLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14951 STRATHMOOR ST, DETROIT, MI 48227-2974
(313) 899-0686
Mailing address
14951 STRATHMOOR ST, DETROIT, MI 48227-2974
(313) 899-0686
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
7718204
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7718204
PROVIDER NUMBER
MI
Enumeration date
08/03/2015
Last updated
08/03/2015
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