Individual
ERICA MATHENEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20310 BRAILE ST, DETROIT, MI 48219-1485
(313) 815-4135
Mailing address
20310 BRAILE ST, DETROIT, MI 48219-1485
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703123944
MI
Other
Enumeration date
10/09/2023
Last updated
10/09/2023
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