Individual
TONIA LYNN MAITLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12237 MARSHALL RD, MONTROSE, MI 48457-8802
(810) 639-6386
Mailing address
12237 MARSHALL RD, MONTROSE, MI 48457-8802
(810) 639-6386
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
AF250065418
MI
Other
Enumeration date
11/27/2006
Last updated
07/08/2007
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