Individual
AANIYA JACKAE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2925 RUSSELL ST, DETROIT, MI 48207-4825
(313) 590-1811
Mailing address
2925 RUSSELL ST, DETROIT, MI 48207-4825
(313) 590-1811
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/07/2023
Last updated
09/07/2023
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