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Individual

AMANDA KOCH GREGORY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
23231 WOODWARD AVE, FERNDALE, MI 48220-1361
(248) 581-8777
Mailing address
23231 WOODWARD AVE, FERNDALE, MI 48220-1361

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6451019758
MI

Other

Enumeration date
01/02/2022
Last updated
01/02/2022
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