Individual
KEYONNA WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLBSW
Contact information
Practice address
279 SUMMIT DR, WATERFORD, MI 48328-3364
(248) 745-4900
(248) 745-6872
Mailing address
279 SUMMIT DR, WATERFORD, MI 48328-3364
(248) 745-4900
(248) 745-6872
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
6802085869
MI
Other
Enumeration date
04/25/2013
Last updated
04/25/2013
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