Individual
SAMANTHA EDMONDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13101 ALLEN RD BLDG 4, SOUTHGATE, MI 48195-2216
(734) 785-7700
Mailing address
13101 ALLEN RD BLDG 4, SOUTHGATE, MI 48195-2216
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
MI
Other
Enumeration date
12/08/2020
Last updated
12/08/2020
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