Individual
EDWARD N. FENNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15600 19 MILE RD, CLINTON TOWNSHIP, MI 48038-3502
(586) 263-8700
(586) 412-7889
Mailing address
605 W BROCKTON AVE, MADISON HEIGHTS, MI 48071-3919
(313) 283-9598
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6852093929
MI
Other
Enumeration date
12/13/2023
Last updated
12/13/2023
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