Individual
BLANCHE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
9605 GRAND RIVER AVE, DETROIT, MI 48204-2139
(313) 834-5930
(313) 834-4541
Mailing address
8826 MACKINAW ST, DETROIT, MI 48204-2372
(313) 728-0351
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
4704174451
MI
Other
Enumeration date
05/20/2014
Last updated
05/20/2014
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