Individual
TANISHA EASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17343 HIDDEN LAKE WAY, NORTHVILLE, MI 48168-2293
(248) 595-2300
Mailing address
11654 VIRGIL, REDFORD, MI 48239-1447
(313) 773-4397
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
10/06/2016
Last updated
12/11/2022
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